Biphasic Outbreak of Invasive Group A Streptococcus Disease in Eldercare Facility, New Zealand
Author
Worthing, KA; Werno, A; Pink, R; McIntyre, L; Carter, GP; Williamson, DA; Davies, MRDate
2020-05-01Source Title
Emerging Infectious DiseasesPublisher
CENTERS DISEASE CONTROL & PREVENTIONUniversity of Melbourne Author/s
Williamson, Deborah; Carter, Glen; Davies, Mark; Worthing, Kate; McIntyre, LiamAffiliation
Microbiology and ImmunologyMetadata
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Journal ArticleCitations
Worthing, K. A., Werno, A., Pink, R., McIntyre, L., Carter, G. P., Williamson, D. A. & Davies, M. R. (2020). Biphasic Outbreak of Invasive Group A Streptococcus Disease in Eldercare Facility, New Zealand. EMERGING INFECTIOUS DISEASES, 26 (5), pp.841-848. https://doi.org/10.3201/eid2605.190131.Access Status
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http://doi.org/10.3201/eid2605.190131Abstract
A 3-month outbreak of invasive group A Streptococcus disease at an eldercare facility, in which 5 persons died, was biphasic. Although targeted chemoprophylaxis contained the initial outbreak, a second phase of the outbreak occurred after infection control processes ended. To retrospectively investigate the genomic epidemiology of the biphasic outbreak, we used whole-genome sequencing and multiple bioinformatics approaches. Analysis of isolates from the outbreak and isolates prospectively collected during the outbreak response indicated a single S. pyogenes emm81 clone among residents and staff members. Outbreak isolates differed from nonoutbreak emm81 isolates by harboring an integrative conjugative genomic element that contained the macrolide resistance determinant erm(TR). This study shows how retrospective high-resolution genomic investigations identified rapid spread of a closed-facilty clonal outbreak that was controlled, but not readily cleared, by infection control management procedures.
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