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Prevalence of the M1UK sublineage among emm1 Streptococcus pyogenes invasive strains isolated in the Czech Republic from December 2022 to May 2023

Czech version

Authors: R. Veselá 1;  S. Vohrnová 1,2;  J. Kozáková 1
Authors‘ workplace: Státní zdravotní ústav, Centrum epidemiologie a mikrobiologie, Národní referenční laboratoř pro streptokokové nákazy 1;  3. lékařská fakulta Univerzity Karlovy, Praha 2
Published in: Epidemiol. Mikrobiol. Imunol. 73, 2024, č. 2, s. 76-83
Category: Original Papers
doi: https://doi.org/10.61568/emi/11-6306/20240424/137080

Overview

Aims: Since December 2022, an increase in invasive disease caused by Streptococcus pyogenes has been observed in the Czech Republic, with a shift in the clinical presentation and age of patients. Unlike in previous years, invasive disease is more common in children and adolescents under 18 years of age and in previously healthy middle-aged adults. An increase has been noticed in the number of S. pyogenes isolates from primarily sterile sites such as haemoculture, cerebrospinal fluid, pleural effusion fluid, joint fluid, and postmortem specimens. Routine emm gene typing revealed emm1 to be the predominant emm type of S. pyogenes. Between January 2023 and July 2023, 46% of all S. pyogenes isolates from invasive cases were assigned to the emm1 type. The globally spread M1UK sublineage is characterized by differences in the expression of seven genes, including the streptococcal pyrogenic toxin A (speA) gene, compared to historical emm1 iGAS strains. The aim of this study is to determine whether the more toxigenic M1UK sublineage is associated with the increase in invasive disease in the Czech Republic.

Methods: Whole genome sequencing of 41 S. pyogenes isolates from patients with invasive disease recovered in the Czech Republic in 2018 and 2019 and from December 2022 to May 2023 was performed using the MiSeq instrument (Illumina). Bioinformatics analysis was performed using freely available online tools the Bacterial and Viral Bioinformatics Resource Center.

Results: Based on whole genome sequencing data of 41 emm1 isolates of S. pyogenes from patients with invasive infectious disease recovered in 2018 and 2019 and from December 2022 to May 2023, the M1UK sublineage was found to be predominant from December 2022 to May 2023.

Conclusion: The reason for the spread of the M1UK sublineage in the Czech Republic late in 2022 and in the first half of 2023 is not entirely clear, but it may be related to reduced immunity due to limited GAS transmission during lockdowns, especially in children. Another factor that may have contributed to the high incidence of invasive infectious diseases is the seasonal circulation of respiratory viruses.

Keywords:

Phylogenetic analysis – whole genome sequencing – Streptococcus pyogenes – GAS – superantigen – outbreak iGAS

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Autoři děkují mikrobiologickým laboratořím za zasílání izolátů S. pyogenes z invazivních onemocnění do NRL/STR.

Podpořeno MZ ČR – RVO („Státní zdravotní ústav –SZU, 75010330“).

Do redakce došlo dne 31. 10. 2023.

Adresa pro korespondenci:
Ing. Renáta Veselá
Státní zdravotní ústav
Šrobárova 49/48
110 00 Praha 10
e-mail: renata.vesela@szu.cz

Labels
Hygiene and epidemiology Medical virology Clinical microbiology
Respiratory syncytial virus (RSV) infection among infants in the first year of life (Czech Republic, 2017–2022)
Streptococcus pneumoniae serotypes 8 and 22F causing invasive pneumococcal disease in the Czech Republic in 2014–2020: whole genome sequencing (WGS) analysis
Povidone-iodine functionalized nanofibers are prophylactic and protect against dissemination of SARS-CoV-2 infection
Analysis of patients with acute hepatitis E treated at the Clinic of Infectology and Travel Medicine in Košice
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Epidemiology, Microbiology, Immunology

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