Detection of toxigenic M1UK lineage group A Streptococcus clones in Taiwan

Chiang-Ni, Chuan; Hsu, Chih-Yun; Yeh, Yu-Hsuan; Chi, Chia-Yu; Wang, Shuying; Tsai, Pei-Jane; Chiu, Cheng-Hsun

doi:10.1016/j.jmii.2024.01.004

Cited by 2 publications

(1 citation statement)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This new clone can be differentiated from M1 global by 27 lineage-defining single-nucleotide polymorphisms (SNP) and is characterized by increased SpeA production (11, 17), resulting from a SNP in the transfer- messenger RNA gene ssrA (15). Numerous countries, including the United States, Canada, the Netherlands, Australia, and Taiwan, have reported on the presence and expansion of the M1 UK lineage among iGAS patients, confirming global dissemination and further evolution of this new variant (15, 18–21).…”

Section: Introductionmentioning

confidence: 76%

Nationwide upsurge in invasive disease in the context of longitudinal surveillance of carriage and invasiveStreptococcus pyogenes2009-2023, the Netherlands: a molecular epidemiological study

Rümke,

Davies,

Vestjens

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Since 2022, many countries reported an upsurge in invasive group A streptococcal (iGAS) infections. We explored whether changes in S. pyogenes carriage rates or emergence of more virulent strains, such as emm1 variants M1UK and M1DK, contributed to the 2022/2023 surge in the Netherlands. Methods We determined emm (sub)type distribution for 2,698 invasive and 351 S. pyogenes carriage isolates collected between January 2009 - March 2023. Genetic evolution of emm1 was analyzed by whole-genome sequencing of 497 emm1 isolates. Findings The nationwide iGAS upsurge coincided with a sharp increase of emm1.0 from 18% (18/100) of invasive isolates in Q1 2022 to 58% (388/670) in Q1 2023 (p<0.0001). M1UK became dominant among invasive emm1 isolates in 2016 and further expanded from 72% in Q1 2022 to 96% in Q1 2023. Phylogenetic comparison revealed evolution and clonal expansion of four new M1UK clades in 2022/2023. DNase Spd1 and superantigen SpeC were acquired in 9% (46/497) of emm1 isolates. S. pyogenes carriage rates and emm1 proportions in carriage isolates remained stable during this surge and the expansion of M1UK in iGAS was not reflected in carriage isolates. Interpretation During the 2022/2023 iGAS surge in the Netherlands, expansion of four new M1UK clades was observed among invasive isolates but not carriage isolates, suggesting increased virulence and fitness of M1UK compared to contemporary M1 strains. The emergence of more virulent clades has important implications for public health strategies such as antibiotic prophylaxis for close contacts of iGAS patients.

show abstract

Section: Introductionmentioning

confidence: 76%

Nationwide upsurge in invasive disease in the context of longitudinal surveillance of carriage and invasiveStreptococcus pyogenes2009-2023, the Netherlands: a molecular epidemiological study

Rümke,

Davies,

Vestjens

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Nationwide upsurge in invasive disease in the context of longitudinal surveillance of carriage and invasive Streptococcus pyogenes 2009–2023, the Netherlands: a molecular epidemiological study

Rümke,

Davies,

Vestjens

et al. 2024

J Clin Microbiol

View full text Add to dashboard Cite

Since 2022, many countries have reported an upsurge in invasive group A streptococcal (iGAS) infections. We explored whether changes in Streptococcus pyogenes carriage rates or emergence of strains with potentially altered virulence, such as emm 1 variants M1 UK and M1 DK , contributed to the 2022/2023 surge in the Netherlands. We determined emm (sub)type distribution for 2,698 invasive and 351 S . pyogenes carriage isolates collected between January 2009 and March 2023. Genetic evolution of emm 1 was analyzed by whole-genome sequencing of 497 emm 1 isolates. The nationwide iGAS upsurge coincided with a sharp increase of emm 1.0 from 18% (18/100) of invasive isolates in Q1 2022 to 58% (388/670) in Q1 2023 (Fisher’s exact test, P < 0.0001). M1 UK became dominant among invasive emm 1 isolates in 2016 and further expanded from 72% in Q1 2022 to 96% in Q1 2023. Phylogenetic comparison revealed evolution and clonal expansion of four new M1 UK clades in 2022/2023. DNase Spd1 and superantigen SpeC were acquired in 9% (46/497) of emm 1 isolates. S. pyogenes carriage rates and emm 1 proportions in carriage isolates remained stable during this surge, and the expansion of M1 UK in iGAS was not reflected in carriage isolates. During the 2022/2023 iGAS surge in the Netherlands, expansion of four new M1 UK clades was observed among invasive isolates, but not carriage isolates, suggesting increased virulence and fitness of M1 UK compared to contemporary M1 strains. The emergence of more virulent clades has important implications for public health strategies such as antibiotic prophylaxis for close contacts of iGAS patients. IMPORTANCE This study describes the molecular epidemiology of invasive group A streptococcal (iGAS) infections in the Netherlands based on >3,000 Streptococcus pyogenes isolates from both asymptomatic carriers and iGAS patients collected before, during, and after the COVID-19 pandemic period (2009–2023) and is the first to assess whether changes in carriage rates or carried emm types contributed to the alarming post-COVID-19 upsurge in iGAS infections. We show that the 2022/2023 iGAS surge coincided with a sharp increase of emm 1, particularly the toxicogenic M1 UK variant, in invasive isolates, but not in carriage isolates. These findings suggest that increased virulence and fitness of M1 UK likely contributes to an increased dissemination between hosts. The emergence of a more virulent and fit lineage has important implications for iGAS control interventions such as antibiotic prophylaxis for close contacts of iGAS patients and calls for a reappraisal of iGAS control interventions and guidelines.

show abstract

Detection of toxigenic M1UK lineage group A Streptococcus clones in Taiwan

Cited by 2 publications

References 42 publications

Nationwide upsurge in invasive disease in the context of longitudinal surveillance of carriage and invasiveStreptococcus pyogenes2009-2023, the Netherlands: a molecular epidemiological study

Nationwide upsurge in invasive disease in the context of longitudinal surveillance of carriage and invasiveStreptococcus pyogenes2009-2023, the Netherlands: a molecular epidemiological study

Nationwide upsurge in invasive disease in the context of longitudinal surveillance of carriage and invasive Streptococcus pyogenes 2009–2023, the Netherlands: a molecular epidemiological study

Contact Info

Product

Resources

About