The bacterial cell membrane acts as a dynamic heme reservoir during group B Streptococcus bloodstream infection

During bloodstream infection, most bacterial pathogens maintain homeostatic levels of heme, which serves as an essential biochemical cofactor and iron source, but becomes toxic at high intracellular concentrations. Well-characterized, surface exposed heme binding and acquisition systems exist in several blood-borne bacterial species. However, some gram-positive bacteria that invade the bloodstream do not encode surface displayed heme acquisition systems, despite showing clear evidence of heme utilization in blood. An example is Streptococcus agalactiae (group B Streptococcus; GBS), which is a major cause of infection in neonatal and immunocompromised populations. Here we show that GBS uses i