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 - Funding Information: The authors would like to thank Agaath Arends-van ‘t Klooster, Ilse de Beer-Schuurman and Claudia Burger for their continued contributions as part of the NRLBM as well as the medical microbiology laboratories for their continued submission of isolates. We thank SURF (www.surf.nl) for their support in using the Lisa Compute Cluster. We thank Jeroen Bos, Sietze Brandes, Fabian Landman, Sjoerd Kuiling and Rob Mariman of the National Institute for Public Health and the Environment (RIVM) for the ONT sequencing of strain 2 220 758. 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 suggesting 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 suggesting 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 - Streptococcus pyogenes
KW - emm typing
KW - public health surveillance: outbreak
KW - whole-genome sequencing
UR - http://www.scopus.com/inward/record.url?scp=85160970101&partnerID=8YFLogxK
U2 - https://doi.org/10.1099/mgen.0.001026
DO - https://doi.org/10.1099/mgen.0.001026
M3 - Article
C2 - 37261428
SN - 2057-5858
VL - 9
JO - Microbial genomics
JF - Microbial genomics
IS - 6
M1 - 001026
ER -