Biphasic Outbreak of Invasive Group A Streptococcus Disease in Eldercare Facility, New Zealand
AuthorWorthing, KA; Werno, A; Pink, R; McIntyre, L; Carter, GP; Williamson, DA; Davies, MR
Source TitleEmerging Infectious Diseases
PublisherCENTERS DISEASE CONTROL & PREVENTION
University of Melbourne Author/sWilliamson, Deborah; Carter, Glen; Davies, Mark; Worthing, Kate; McIntyre, Liam
AffiliationMicrobiology and Immunology
Document TypeJournal Article
CitationsWorthing, 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 StatusAccess this item via the Open Access location
Open Access URLPublished version
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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