Author Correction: Pathogenesis, epidemiology and control of Group A Streptococcus infection

Brouwer, Stephan; Rivera-Hernández, Tania; Curren, Bodie; Harbison-Price, Nichaela; Oliveira, David M. P. De; Jespersen, Magnus G.; Davies, Mark R.; Walker, Mark J.

doi:10.1038/s41579-023-00939-6

Cited by 4 publications

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“…StrepA has evolved several strategies that allow the evasion or subversion of the host immune response, enabling it to establish and maintain infections 8 9. StrepA proteins with immune evasion properties include M protein, hyaluronic acid capsule, streptolysin O (SLO) and S (SLS), DNases, adhesins, proteases and pyrogenic toxins 8 10…”

Section: Key Research Topicmentioning

confidence: 99%

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Research opportunities for the primordial prevention of rheumatic fever and rheumatic heart disease—streptococcal vaccine development: a national heart, lung and blood institute workshop report

Fulurija,

Cunningham,

Korotkova

et al. 2023

BMJ Glob Health

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Streptococcus pyogenes,also known as group A streptococcus (StrepA), is a bacterium that causes a range of human diseases, including pharyngitis, impetigo, invasive infections, and post-infection immune sequelae such as rheumatic fever and rheumatic heart disease. StrepA infections cause some of the highest burden of disease and death in mostly young populations in low-resource settings. Despite decades of effort, there is still no licensed StrepA vaccine, which if developed, could be a cost-effective way to reduce the incidence of disease. Several challenges, including technical and regulatory hurdles, safety concerns and a lack of investment have hindered StrepA vaccine development. Barriers to developing a StrepA vaccine must be overcome in the future by prioritising key areas of research including greater understanding of StrepA immunobiology and autoimmunity risk, better animal models that mimic human disease, expanding the StrepA vaccine pipeline and supporting vaccine clinical trials. The development of a StrepA vaccine is a complex and challenging process that requires significant resources and investment. Given the global burden of StrepA infections and the potential for a vaccine to save lives and livelihoods, StrepA vaccine development is an area of research that deserves considerable support. This report summarises the findings of the Primordial Prevention Working Group-VAX, which was convened in November 2021 by the National Heart, Lung, and Blood Institute. The focus of this report is to identify research gaps within the current StrepA vaccine landscape and find opportunities and develop priorities to promote the rapid and successful advancement of StrepA vaccines.

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Section: Key Research Topicmentioning

confidence: 99%

“… 8 9 StrepA proteins with immune evasion properties include M protein, hyaluronic acid capsule, streptolysin O (SLO) and S (SLS), DNases, adhesins, proteases and pyrogenic toxins. 8 10 …”

Section: Key Research Topicmentioning

confidence: 99%

Research opportunities for the primordial prevention of rheumatic fever and rheumatic heart disease—streptococcal vaccine development: a national heart, lung and blood institute workshop report

Fulurija,

Cunningham,

Korotkova

et al. 2023

BMJ Glob Health

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“…Additional pathogen virulence gene expression, as well as resistance to host immune mechanisms, may result in microbial entry into sterile sites (e.g. blood, bone, joint fluid or deep tissue) causing invasive group A streptococcus (iGAS) infection [4, 5]. Patient risk factors for developing iGAS include older age, immune disorders, diabetes and intravenous drug use [6].…”

Section: Introductionmentioning

confidence: 99%

Insights gained from sequencing Australian non-invasive and invasive Streptococcus pyogenes isolates

Butler,

Story,

Green

et al. 2024

Microbial Genomics

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Epidemiological data have indicated that invasive infections caused by the Gram-positive cocci Streptococcus pyogenes (group A streptococcus, GAS) have increased in many Australian states over the past two decades. In July 2022, invasive GAS (iGAS) infections became nationally notifiable in Australia via public-health agencies. Surveillance for S. pyogenes infections has been sporadic within the state of New South Wales (NSW). This has led to a lack of genetic data on GAS strains in circulation, particularly for non-invasive infections, which are the leading cause of GAS’s burden on the Australian healthcare system. To address this gap, we used whole-genome sequencing to analyse the genomes of 318 S . pyogenes isolates collected within two geographical regions of NSW. Invasive isolates were collected in 2007–2017, whilst non-invasive isolates were collected in 2019–2021. We found that at least 66 different emm-types were associated with clinical disease within NSW. There was no evidence of any Australian-specific clones in circulation. The M1UK variant of the emm1 global pandemic clone (M1global) has been detected in our isolates from 2013 onwards. We detected antimicrobial-resistance genes (mainly tetM, ermA or ermB genes) in less than 10 % of our 318 isolates, which were more commonly associated with non-invasive infections. Superantigen virulence gene carriage was reasonably proportionate between non-invasive and invasive infection isolates. Our study adds rich data on the genetic makeup of historical S. pyogenes infections within Australia. Ongoing surveillance of invasive and non-invasive GAS infections within NSW by whole-genome sequencing is warranted to inform on outbreaks, antimicrobial resistance and vaccine coverage.

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“…Streptococcus pyogenes (Group A Streptococcus, GAS) is a human-specific Gram-positive coccus responsible for a broad spectrum of diseases differing in clinical presentation and severity (Brouwer et al, 2023 ). Primary infection sites are usually upper airways and skin, where non-invasive GAS infections occur and from where the pathogen can be transmitted to a new host or can disseminate causing invasive disease (iGAS) such as empyema (infection of the pleural cavity), streptococcal toxic shock syndrome (STSS) or necrotising fasciitis (Efstratiou and Lamagni, 2022 ; Stevens and Bryant, 2022a , b ; GOV.UK, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

“…Incidence of GAS diseases varies with season and geographical location. Yet, while outbreaks of non-invasive infections are fairly common in occurence, iGAS are fortunately rare conditions (Efstratiou and Lamagni, 2022 ; Brouwer et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Increase in invasive group A streptococcal infections in Milan, Italy: a genomic and clinical characterization

Mangioni,

Fox,

Saltini

et al. 2024

Front. Microbiol.

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BackgroundGroup A Streptococcus (GAS) causes multiple clinical manifestations, including invasive (iGAS) or even life-threatening (severe-iGAS) infections. After the drop in cases during COVID-19 pandemic, in 2022 a sharp increase of GAS was reported globally.MethodsGAS strains collected in 09/2022–03/2023 in two university hospitals in Milan, Italy were retrospectively analyzed. Clinical/epidemiological data were combined with whole-genome sequencing to: (i) define resistome/virulome, (ii) identify putative transmission chains, (iii) explore associations between emm-types and clinical severity.ResultsTwenty-eight isolates were available, 19/28 (67.9%) from adults and 9/28 (32.1%) from pediatric population. The criteria for iGAS were met by 19/28 cases (67.9%), of which 11/19 (39.3%) met the further criteria for severe-iGAS. Pediatric cases were mainly non-invasive infections (8/9, 88.9%), adult cases were iGAS and severe-iGAS in 18/19 (94.7%) and 10/19 (52.6%), respectively. Thirteen emm-types were detected, the most prevalent being emm1 and emm12 (6/28 strains each, 21.4%). Single nucleotide polymorphism (SNP) analysis of emm1.0 and emm12.0 strains revealed pairwise SNP distance always >10, inconsistent with unique transmission chains. Emm12.0-type, found to almost exclusively carry virulence factors speH and speI, was mainly detected in children and in no-iGAS infections (55.6 vs. 5.3%, p = 0.007 and 66.7 vs. 0.0%, p < 0.001, respectively), while emm1.0-type was mainly detected in severe-iGAS (0.0 vs. 45.5%, p = 0.045).ConclusionsThis study showed that multiple emm-types contributed to a 2022/2023 GAS infection increase in two hospitals in Milan, with no evidence of direct transmission chains. Specific emm-types could be associated with disease severity or invasiveness. Overall, these results support the integration of classical epidemiological studies with genomic investigation to appropriately manage severe infections and improve surveillance.

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Author Correction: Pathogenesis, epidemiology and control of Group A Streptococcus infection

Cited by 4 publications

References 0 publications

Research opportunities for the primordial prevention of rheumatic fever and rheumatic heart disease—streptococcal vaccine development: a national heart, lung and blood institute workshop report

Research opportunities for the primordial prevention of rheumatic fever and rheumatic heart disease—streptococcal vaccine development: a national heart, lung and blood institute workshop report

Insights gained from sequencing Australian non-invasive and invasive Streptococcus pyogenes isolates

Increase in invasive group A streptococcal infections in Milan, Italy: a genomic and clinical characterization

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