Table 1.

Demonstrated virulence factors of streptococci species, disease caused and the associated social and financial cost with the disease.

Organism	Diseases	Adherence Site	Estimated Cases/Costs
S. mutans	Dental caries	Tooth surface, other bacteria present in the biofilm on the surface of the tooth [5]	500 million visits to dentists and an estimated $108 billion spent on dental services in united states in 2010 [27]
	Dental plaque
	Endocarditis
S. pyogenes	Pharyngitis	Mucosal surfaces of pharynx, skin [25]	1–2.6 million cases of strep throat, erythromycin-resistant, invasive S. pyogenes causes 1300 illnesses and 160 deaths in united states each year. The total cost (medical and non-medical ) of group A streptococcal pharyngitis among school aged children in united states ranges from $224 to $539 million per year [27]
	Cellulitis
	Streptococcal toxic-shock syndrome
	Necrotizing fasciitis
	Rheumatic fever
	Sequela
	Erysipelas glomerulonephritis
S. agalactiae	Neonatal sepsis	Mucosal surfaces of vaginas and recta of pregnant women, skin [32]	Clindamycin-resistant S. agalactiae causes an estimated 7600 illnesses and 440 deaths yearly in U.S. 27,000 cases of severe S. agalactiae disease, such as blood infections or meningitis, occurred in 2011, causing 1575 deaths in U.S. [27]
	Meningitis
	Systemic infection in immuno-compromised individuals
S. pneumoniae	Otitis media	Mucous membranes of the nasopharynx [33]	Cases of resistant pneumococcal pneumonia result in about 32,000 additional doctor visits and about 19,000 additional hospitalizations and costs associated are approximately $96 million in U.S. [27]
	Bacteraemia
	Pneumonia
	Meningitis
	Bronchitis
	Sinusitis
	Laryngitis
	Epiglottitis