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    Biphasic Outbreak of Invasive Group A Streptococcus Disease in Eldercare Facility, New Zealand

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    Author
    Worthing, KA; Werno, A; Pink, R; McIntyre, L; Carter, GP; Williamson, DA; Davies, MR
    Date
    2020-05-01
    Source Title
    Emerging Infectious Diseases
    Publisher
    CENTERS DISEASE CONTROL & PREVENTION
    University of Melbourne Author/s
    Williamson, Deborah; Carter, Glen; Davies, Mark; Worthing, Kate; McIntyre, Liam
    Affiliation
    Microbiology and Immunology
    Metadata
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    Document Type
    Journal Article
    Citations
    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
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/254216
    DOI
    10.3201/eid2605.190131
    Open Access URL
    http://doi.org/10.3201/eid2605.190131
    Abstract
    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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