TY - JOUR
T1 - Novel emm4 lineage associated with an upsurge in invasive group A streptococcal disease in the Netherlands, 2022
AU - van der Putten, Boas C.L.
AU - Bril-Keijzers, Wendy C.M.
AU - Rumke, Lidewij W.
AU - Vestjens, Stefan M.T.
AU - Koster, Linda A.M.
AU - Willemsen, Marloes
AU - van Houten, Marlies A.
AU - Rots, Nynke Y.
AU - Vlaminckx, Bart J.M.
AU - de Gier, Brechje
AU - van Sorge, Nina M.
N1 - Publisher Copyright:
© 2023 The Authors.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Invasive group A streptococcal (iGAS) disease cases increased in the first half of 2022 in the Netherlands, with a remarkably high proportion of emm4 isolates. Whole-genome sequence analysis of 66 emm4 isolates, 40 isolates from the pre-coronavirus disease 2019 (COVID-19) pandemic period 2009–2019 and 26 contemporary isolates from 2022, identified a novel Streptococcus pyogenes lineage (M4NL22 ), which accounted for 85 % of emm4 iGAS cases in 2022. Surprisingly, we detected few isolates of the emm4 hypervirulent clone, which has replaced nearly all other emm4 in the USA and the UK. M4NL22 displayed genetic differences compared to other emm4 strains, although these were of unclear biological significance. In publicly available data, we identified a single Norwegian isolate belonging to M4NL22, which was sampled after the isolates from this study, possibly sug-gesting export of M4NL22 to Norway. In conclusion, our study identified a novel S. pyogenes emm4 lineage underlying an increase of iGAS disease in early 2022 in the Netherlands and the results have been promptly communicated to public health officials.
AB - Invasive group A streptococcal (iGAS) disease cases increased in the first half of 2022 in the Netherlands, with a remarkably high proportion of emm4 isolates. Whole-genome sequence analysis of 66 emm4 isolates, 40 isolates from the pre-coronavirus disease 2019 (COVID-19) pandemic period 2009–2019 and 26 contemporary isolates from 2022, identified a novel Streptococcus pyogenes lineage (M4NL22 ), which accounted for 85 % of emm4 iGAS cases in 2022. Surprisingly, we detected few isolates of the emm4 hypervirulent clone, which has replaced nearly all other emm4 in the USA and the UK. M4NL22 displayed genetic differences compared to other emm4 strains, although these were of unclear biological significance. In publicly available data, we identified a single Norwegian isolate belonging to M4NL22, which was sampled after the isolates from this study, possibly sug-gesting export of M4NL22 to Norway. In conclusion, our study identified a novel S. pyogenes emm4 lineage underlying an increase of iGAS disease in early 2022 in the Netherlands and the results have been promptly communicated to public health officials.
KW - emm typing
KW - public health surveillance: outbreak
KW - Streptococcus pyogenes
KW - whole-genome sequencing
UR - http://www.scopus.com/inward/record.url?scp=85160970101&partnerID=8YFLogxK
U2 - 10.1099/mgen.0.001026
DO - 10.1099/mgen.0.001026
M3 - Article
C2 - 37261428
AN - SCOPUS:85160970101
VL - 9
JO - Microbial genomics
JF - Microbial genomics
IS - 6
M1 - 001026
ER -