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    Increase of emm1 isolates among group A Streptococcus strains causing scarlet fever in Shanghai, China

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    Author
    Chen, M; Cai, J; Davies, MR; Li, Y; Zhang, C; Yao, W; Kong, D; Pan, H; Zhang, X; Zeng, M; ...
    Date
    2020-09-01
    Source Title
    International Journal of Infectious Diseases
    Publisher
    ELSEVIER SCI LTD
    University of Melbourne Author/s
    Davies, Mark
    Affiliation
    Microbiology and Immunology
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Chen, 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 Status
    Open Access
    URI
    http://hdl.handle.net/11343/252469
    DOI
    10.1016/j.ijid.2020.06.053
    Abstract
    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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