TY - JOUR
T1 - A worldwide population of Streptococcus pyogenes strains circulating among school-aged children in Auckland, New Zealand
T2 - a genomic epidemiology analysis.
AU - Lacey, Jake A
AU - Bennett, Julie
AU - James, Taylah B
AU - Hines, Benjamin S
AU - Chen, Tiffany
AU - Lee, Darren
AU - Sika-Paotonu, Dianne
AU - Anderson, Anneka
AU - Harwood, Matire
AU - Tong, Steven Y C
AU - Baker, Michael G
AU - Williamson, Deborah A
AU - Moreland, Nicole J
N1 - Funding: The work was supported by the Health Research Council of New Zealand (HRC), award number 16/005.
PY - 2024/1
Y1 - 2024/1
N2 - Background: Acute rheumatic fever (ARF) is a serious post-infectious sequala of Group A Streptococcus (GAS, Streptococcus pyogenes). In New Zealand (NZ) ARF is a major cause of health inequity. This study describes the genomic analysis of GAS isolates associated with childhood skin and throat infections in Auckland NZ. Methods: Isolates (n = 469) collected between March 2018 and October 2019 from the throats and skin of children (5-14 years) underwent whole genomic sequencing. Equal representation across three ethnic groups was ensured through sample quotas with isolates obtained from Indigenous Māori (n = 157, 33%), NZ European/Other (n = 149, 32%) and Pacific Peoples children (n = 163, 35%). Using in silico techniques isolates were classified, assessed for diversity, and examined for distribution differences between groups. Comparisons were also made with GAS strains identified globally. Findings: Genomic analysis revealed a diverse population consisting of 65 distinct sequence clusters. These sequence clusters spanned 49 emm-types, with 11 emm-types comprised of several, distinct sequence clusters. There is evidence of multiple global introductions of different lineages into the population, as well as local clonal expansion. The M1 UK lineage comprised 35% of all emm1 isolates. Interpretation: The GAS population was characterized by a high diversity of strains, resembling patterns observed in low- and middle-income countries. However, strains associated with outbreaks and antimicrobial resistance commonly found in high-income countries were also observed. This unique combination poses challenges for vaccine development, disease management and control.
AB - Background: Acute rheumatic fever (ARF) is a serious post-infectious sequala of Group A Streptococcus (GAS, Streptococcus pyogenes). In New Zealand (NZ) ARF is a major cause of health inequity. This study describes the genomic analysis of GAS isolates associated with childhood skin and throat infections in Auckland NZ. Methods: Isolates (n = 469) collected between March 2018 and October 2019 from the throats and skin of children (5-14 years) underwent whole genomic sequencing. Equal representation across three ethnic groups was ensured through sample quotas with isolates obtained from Indigenous Māori (n = 157, 33%), NZ European/Other (n = 149, 32%) and Pacific Peoples children (n = 163, 35%). Using in silico techniques isolates were classified, assessed for diversity, and examined for distribution differences between groups. Comparisons were also made with GAS strains identified globally. Findings: Genomic analysis revealed a diverse population consisting of 65 distinct sequence clusters. These sequence clusters spanned 49 emm-types, with 11 emm-types comprised of several, distinct sequence clusters. There is evidence of multiple global introductions of different lineages into the population, as well as local clonal expansion. The M1 UK lineage comprised 35% of all emm1 isolates. Interpretation: The GAS population was characterized by a high diversity of strains, resembling patterns observed in low- and middle-income countries. However, strains associated with outbreaks and antimicrobial resistance commonly found in high-income countries were also observed. This unique combination poses challenges for vaccine development, disease management and control.
U2 - 10.1016/j.lanwpc.2023.100964
DO - 10.1016/j.lanwpc.2023.100964
M3 - Article
C2 - 38035130
SN - 2666-6065
VL - 42
SP - 1
EP - 11
JO - The Lancet Regional Health. Western Pacific
JF - The Lancet Regional Health. Western Pacific
M1 - 100964
ER -
