Increase of emm1 isolates among group A Streptococcus strains causing scarlet fever in Shanghai, China
AuthorChen, M; Cai, J; Davies, MR; Li, Y; Zhang, C; Yao, W; Kong, D; Pan, H; Zhang, X; Zeng, M; ...
Source TitleInternational Journal of Infectious Diseases
PublisherELSEVIER SCI LTD
University of Melbourne Author/sDavies, Mark
AffiliationMicrobiology and Immunology
Document TypeJournal Article
CitationsChen, M., Cai, J., Davies, M. R., Li, Y., Zhang, C., Yao, W., Kong, D., Pan, H., Zhang, X., Zeng, M. & Chen, M. (2020). Increase of emm1 isolates among group A Streptococcus strains causing scarlet fever in Shanghai, China. INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, 98, pp.305-314. https://doi.org/10.1016/j.ijid.2020.06.053.
Access StatusOpen Access
OBJECTIVE: Scarlet fever epidemics caused by group A Streptococcus (GAS) have been ongoing in China since 2011. However, limited data are available on the dynamic molecular characterizations of the epidemic strains. METHOD: Epidemiological data of scarlet fever in Shanghai were obtained from the National Notifiable Infectious Disease Surveillance System. Throat swabs of patients with scarlet fever and asymptomatic school-age children were cultured. Illumina sequencing was performed on 39emm1 isolates. RESULTS: The annual incidence of scarlet fever was 7.5-19.4/100,000 persons in Shanghai during 2011-2015, with an average GAS carriage rate being 7.6% in school-age children. The proportion ofemm1 GAS strains increased from 3.8% in 2011 to 48.6% in 2014; they harbored a superantigen profile similar to emm12 isolates, except for the speA gene. Two predominant clones, SH001-emm12, and SH002-emm1, circulated in 66.9% of scarlet fever cases and 44.8% of carriers. Genomic analysis showed emm1 isolates throughout China constituted distinct clades, enriched by the presence of mobile genetic elements carrying the multidrug-resistant determinants ermB and tetM and virulence genes speA, speC, and spd1. CONCLUSION: A significant increase in the proportion ofemm1 strains occurred in the GAS population, causing scarlet fever in China. Ongoing surveillance is warranted to monitor the dynamic changes of GAS clones.
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