Many pathogens engage host cell surface glycosaminoglycans, but redundancy in pathogen adhesins and host glycosaminoglycan-anchoring proteins (heparan sulfate proteoglycans) has limited the understanding of the importance of glycosaminoglycan binding during infection. The alpha C protein of group B streptococcus, a virulence determinant for this neonatal human pathogen, binds to host glycosaminoglycan and mediates the entry of bacteria into human cells. We studied alpha C protein-glycosaminoglycan binding in Drosophila melanogaster, whose glycosaminoglycan repertoire resembles that of humans but whose genome includes only three characterized membrane heparan sulfate proteoglycan genes. The knockdown of glycosaminoglycan polymerases or of heparan sulfate proteoglycans reduced the cellular binding of alpha C protein. The interruption of alpha C protein-glycosaminoglycan binding was associated with longer host survival and a lower bacterial burden. These data indicate that the glycosaminoglycan-alpha C protein interaction involves multiple heparan sulfate proteoglycans and impairs bacterial killing. Host glycosaminoglycans, anchored by multiple proteoglycans, thereby determine susceptibility to infection. Because there is homology between Drosophila and human glycosaminoglycan/proteoglycan structures and many pathogens express glycosaminoglycan-binding structures, our data suggest that interfering with glycosaminoglycan binding may protect against infections in humans.Streptococcus agalactiae (group B streptococcus [GBS]) commonly colonizes human mucosal surfaces and also causes devastating invasive infections, particularly in neonates. The main identified mammalian host defense against GBS is opsonophagocytosis, requiring phagocytes, complement, and specific antibody. GBS virulence determinants include surface structures such as capsular polysaccharide, cytolysin, and the protein designated Dalanylation of lipoteichoic acid (DltA) (10,22,25). Protecting the organism from phagocytosis, capsular polysaccharide is a highmolecular-weight polymer composed of more than 100 repeating pentasaccharide units, each with a terminal sialic acid moiety. Cytolysin promotes enhanced GBS survival during infection by contributing to phagocyte cytolysis and apoptosis and by helping shield GBS from oxidative damage (18). Deficiency in DltA is associated with increased susceptibility to phagocytosis and to antimicrobial peptides (25).Alpha C protein (ACP) is an important GBS virulence determinant that binds to host cell glycosaminoglycan (GAG) and mediates bacterial entry into human cells (3, 4, 5) in vitro. We aimed to further characterize the host cell receptor and to determine the importance of the ACP-GAG interactions in vivo.GAGs are highly sulfated modified polysaccharide polymers anchored in the cell membrane by a protein core as a heparan sulfate proteoglycan (HSPG). Among the most abundant cell surface GAGs are heparan sulfate (HS) and chondroitin sulfate (CS). HS consists of iduronic or glucuronic acid and Nacetylglucosamine...