The ongoing Streptococcus pyogenes (Group A Streptococcus) outbreak in London, United Kingdom, in December 2022 : a molecular epidemiology study
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: Epidemiological and whole-genome sequencing analysis of an ongoing outbreak of Streptococcus pyogenes (Group A Streptococcus) in London (United Kingdom).
METHODS: Prospective identification of Group A Streptococcus cases from a diagnostic laboratory serving central and south London between 27 November and 10 December 2022. Case notes were reviewed and isolates were retrieved. Case numbers were compared with the previous 5 years. Whole-genome sequencing was performed with long-read, nanopore technology for emm typing and identification of superantigen genes. Associations of pathogen-related factors with an invasive disease were assessed by single-variable and multi-variable logistic regression.
RESULTS: Case numbers began increasing in October 2022 from a baseline of 2.0 cases per day, and in December 2022, the average daily case numbers reached 10.8 cases per day, four-fold the number usually seen in winter. A total of 113 cases were identified during the prospective study period. Three quarters (86/113, 76%) were paediatric cases, including 2 deaths. Of 113 cases, 11 (10%) were invasive. In total, 56 isolates were successfully sequenced, including 10 of 11 (91%) invasive isolates. The emm12 (33/56, 59%) and emm1 (9/56, 16%) types were predominant, with 7 of 9 (78%) emm1 isolates being from the M1uk clone. The majority of invasive isolates had superantigen genes spea (7/10, 70%) and spej (8/10, 80%), whereas, in non-invasive isolates, these superantigen genes were found less frequently (spea: 5/46, 11% and spej: 7/46, 15%). By multivariable analysis of pathogen-related factors, spea (OR 8.9, CI 1.4-57, p 0.020) and spej (OR 12, CI 1.8-78, p 0.011) were associated with invasive disease.
CONCLUSIONS: emm12 and emm1 types predominate in the ongoing outbreak, which mainly affects children. In this outbreak, the spea and spej superantigen genes are associated with the severity of presentation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases - 29(2023), 7 vom: 15. Juli, Seite 887-890 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Alcolea-Medina, Adela [VerfasserIn] |
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| Links: |
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| Themen: |
Antigens, Bacterial |
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| Anmerkungen: |
Date Completed 19.06.2023 Date Revised 06.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.cmi.2023.03.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Alcolea-Medina, Adela |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The ongoing Streptococcus pyogenes (Group A Streptococcus) outbreak in London, United Kingdom, in December 2022 |b a molecular epidemiology study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 19.06.2023 | ||
| 500 | |a Date Revised 06.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: Epidemiological and whole-genome sequencing analysis of an ongoing outbreak of Streptococcus pyogenes (Group A Streptococcus) in London (United Kingdom) | ||
| 520 | |a METHODS: Prospective identification of Group A Streptococcus cases from a diagnostic laboratory serving central and south London between 27 November and 10 December 2022. Case notes were reviewed and isolates were retrieved. Case numbers were compared with the previous 5 years. Whole-genome sequencing was performed with long-read, nanopore technology for emm typing and identification of superantigen genes. Associations of pathogen-related factors with an invasive disease were assessed by single-variable and multi-variable logistic regression | ||
| 520 | |a RESULTS: Case numbers began increasing in October 2022 from a baseline of 2.0 cases per day, and in December 2022, the average daily case numbers reached 10.8 cases per day, four-fold the number usually seen in winter. A total of 113 cases were identified during the prospective study period. Three quarters (86/113, 76%) were paediatric cases, including 2 deaths. Of 113 cases, 11 (10%) were invasive. In total, 56 isolates were successfully sequenced, including 10 of 11 (91%) invasive isolates. The emm12 (33/56, 59%) and emm1 (9/56, 16%) types were predominant, with 7 of 9 (78%) emm1 isolates being from the M1uk clone. The majority of invasive isolates had superantigen genes spea (7/10, 70%) and spej (8/10, 80%), whereas, in non-invasive isolates, these superantigen genes were found less frequently (spea: 5/46, 11% and spej: 7/46, 15%). By multivariable analysis of pathogen-related factors, spea (OR 8.9, CI 1.4-57, p 0.020) and spej (OR 12, CI 1.8-78, p 0.011) were associated with invasive disease | ||
| 520 | |a CONCLUSIONS: emm12 and emm1 types predominate in the ongoing outbreak, which mainly affects children. In this outbreak, the spea and spej superantigen genes are associated with the severity of presentation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bacterial typing | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a Group A Streptococcus | |
| 650 | 4 | |a Streptococcus pyogenes | |
| 650 | 4 | |a Whole-genome sequencing | |
| 650 | 7 | |a Antigens, Bacterial |2 NLM | |
| 650 | 7 | |a Superantigens |2 NLM | |
| 650 | 7 | |a Bacterial Outer Membrane Proteins |2 NLM | |
| 700 | 1 | |a Snell, Luke B |e verfasserin |4 aut | |
| 700 | 1 | |a Alder, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Charalampous, Themoula |e verfasserin |4 aut | |
| 700 | 1 | |a Williams, Tom G S |e verfasserin |4 aut | |
| 700 | 0 | |a Synnovis Microbiology Laboratory Group |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Mark K I |e verfasserin |4 aut | |
| 700 | 1 | |a Al-Yaakoubi, Noor |e verfasserin |4 aut | |
| 700 | 1 | |a Humayun, Gul |e verfasserin |4 aut | |
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| 700 | 1 | |a Edgeworth, Jonathan D |e verfasserin |4 aut | |
| 700 | 1 | |a Athitha, Vasanthini |e investigator |4 oth | |
| 700 | 1 | |a Begum, Jahaedea |e investigator |4 oth | |
| 700 | 1 | |a Bonaiti, Massimo |e investigator |4 oth | |
| 700 | 1 | |a Brennan, Julie |e investigator |4 oth | |
| 700 | 1 | |a Bryan, Lisa |e investigator |4 oth | |
| 700 | 1 | |a Cerda, Albert |e investigator |4 oth | |
| 700 | 1 | |a Cliff, Penelope R |e investigator |4 oth | |
| 700 | 1 | |a Hoang, Luong Huw |e investigator |4 oth | |
| 700 | 1 | |a Merrill, Tammy V |e investigator |4 oth | |
| 700 | 1 | |a Naumova, Denitsa |e investigator |4 oth | |
| 700 | 1 | |a Parvez, Rayhan |e investigator |4 oth | |
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| 700 | 1 | |a Wray, Diane |e investigator |4 oth | |
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