Novel<i>emm</i>4 lineage associated with an upsurge in invasive group A streptococcal disease in the Netherlands, 2022

Putten, Boas C L van der; Bril-Keijzers, Wendy C M; Rümke, Lidewij W; Vestjens, Stefan M T; Koster, Linda A M; Willemsen, Marloes; Vlaminckx, Bart J. M.; Gier, Brechje de; Sorge, Nina M. van

doi:10.1101/2022.12.31.522331

2023

DOI: 10.1101/2022.12.31.522331

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Novelemm4 lineage associated with an upsurge in invasive group A streptococcal disease in the Netherlands, 2022

Boas C L van der Putten¹,

Wendy C M Bril-Keijzers²,

Lidewij W Rümke

et al.

Abstract: Invasive group A streptococcal (iGAS) disease cases increased in the first half year of 2022 in the Netherlands with a remarkably high proportion of emm4 isolates. Whole-genome sequence analysis of emm4 isolates from 2009-2022 identified a novel GAS lineage, which accounted for 85% emm4 iGAS cases in 2022.

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A core-genome multilocus sequence typing scheme for the detection of genetically related Streptococcus pyogenes clusters

Toorop,

Kraakman,

Hoogendijk

et al. 2023

J Clin Microbiol

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The recently observed increase in invasive Streptococcus pyogenes infections causes concern in Europe. However, conventional molecular typing methods lack discriminatory power to aid investigations of outbreaks caused by S. pyogenes . Therefore, there is an urgent need for high-resolution molecular typing methods to assess genetic relatedness between S. pyogenes isolates. In the current study, we aimed to develop a novel high-resolution core-genome multilocus sequence typing (cgMLST) scheme for S. pyogenes and compared its discriminatory power to conventional molecular typing methods. The cgMLST scheme was designed with the commercial Ridom SeqSphere+ software package. To define a cluster threshold, the scheme was evaluated using publicly available data from nine defined S. pyogenes outbreaks in the United Kingdom. The cgMLST scheme was then applied to 23 isolates from a suspected S. pyogenes outbreak and 117 S . pyogenes surveillance isolates both from the Netherlands. MLST and emm -typing results were used for comparison to cgMLST results. The allelic differences between isolates from defined outbreaks ranged between 6 and 31 for isolates with the same emm- type, resulting in a proposed cluster threshold of < 5 allelic differences out of 1,095 target loci. Seven out of twenty-three (30%) isolates from the suspected outbreak had an allelic difference of < 2, thereby identifying a potential cluster that could not be linked to other isolates. The proposed cgMLST scheme shows a higher discriminatory ability when compared to conventional typing methods. The rapid and simple analysis workflow allows for extended detection of clusters of potential outbreak isolates and surveillance and may facilitate the sharing of sequencing results between (inter)national laboratories.

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A core-genome multilocus sequence typing scheme for the detection of genetically related Streptococcus pyogenes clusters

Toorop,

Kraakman,

Hoogendijk

et al. 2023

J Clin Microbiol

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show abstract

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Novelemm4 lineage associated with an upsurge in invasive group A streptococcal disease in the Netherlands, 2022

Cited by 1 publication

References 35 publications

A core-genome multilocus sequence typing scheme for the detection of genetically related Streptococcus pyogenes clusters

A core-genome multilocus sequence typing scheme for the detection of genetically related Streptococcus pyogenes clusters

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