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A worldwide population of Streptococcus pyogenes strains circulating among school-aged children in Auckland, New Zealand: a genomic epidemiology analysis.


ABSTRACT:

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 M1UK 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.

Funding

The work was supported by the Health Research Council of New Zealand (HRC), award number 16/005.

SUBMITTER: Lacey JA 

PROVIDER: S-EPMC10684382 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Publications

A worldwide population of <i>Streptococcus pyogenes</i> strains circulating among school-aged children in Auckland, New Zealand: a genomic epidemiology analysis.

Lacey Jake A JA   Bennett Julie J   James Taylah B TB   Hines Benjamin S BS   Chen Tiffany T   Lee Darren D   Sika-Paotonu Dianne D   Anderson Anneka A   Harwood Matire M   Tong Steven Y C SYC   Baker Michael G MG   Williamson Deborah A DA   Moreland Nicole J NJ  

The Lancet regional health. Western Pacific 20231114


<h4>Background</h4>Acute rheumatic fever (ARF) is a serious post-infectious sequala of Group A <i>Streptococcus</i> (GAS, <i>Streptococcus pyogenes</i>). 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.<h4>Methods</h4>Isolates (n = 469) collected between March 2018 and October 2019 from the throats and skin of children (5-14 years) underwent whole genomic seq  ...[more]

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