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Increase of emm1 isolates among group A Streptococcus strains causing scarlet fever in Shanghai, China

International Journal of Infectious Diseases. 2020;98:305-314

 

Journal Homepage

Journal Title: International Journal of Infectious Diseases

ISSN: 1201-9712 (Print); 1878-3511 (Online)

Publisher: Elsevier

Society/Institution: International Society for Infectious Diseases

LCC Subject Category: Medicine: Internal medicine: Infectious and parasitic diseases

Country of publisher: Netherlands

Language of fulltext: English

Full-text formats available: PDF, HTML, ePUB

 

AUTHORS


Mingliang Chen (Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, PR China; Department of Microbiology, Shanghai Institutes of Preventive Medicine, Shanghai, PR China)

Jiehao Cai (Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, PR China)

Mark R. Davies (Department of Microbiology and Immunology, the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Victoria, Australia)

Yuefang Li (Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, PR China)

Chi Zhang (Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, PR China)

Weilei Yao (Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, PR China)

Dechuan Kong (Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, PR China)

Hao Pan (Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, PR China)

Xi Zhang (Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, PR China)

Mei Zeng (Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, PR China; Corresponding author at: Department of Infectious Diseases, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai 201102, PR China)

Min Chen (Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, PR China; Corresponding author at: Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, PR China.)

EDITORIAL INFORMATION

Peer review

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Instructions for authors

Time From Submission to Publication: 24 weeks

 

Abstract | Full Text

Objective: Scarlet fever epidemics caused by group A Streptococcus (GAS) have been ongoing in China since 2011. However, limited data are available on the dynamic molecular characterizations of the epidemic strains. Method: Epidemiological data of scarlet fever in Shanghai were obtained from the National Notifiable Infectious Disease Surveillance System. Throat swabs of patients with scarlet fever and asymptomatic school-age children were cultured. Illumina sequencing was performed on 39emm1 isolates. Results: The annual incidence of scarlet fever was 7.5–19.4/100,000 persons in Shanghai during 2011–2015, with an average GAS carriage rate being 7.6% in school-age children. The proportion ofemm1 GAS strains increased from 3.8% in 2011 to 48.6% in 2014; they harbored a superantigen profile similar to emm12 isolates, except for the speA gene. Two predominant clones, SH001-emm12, and SH002-emm1, circulated in 66.9% of scarlet fever cases and 44.8% of carriers. Genomic analysis showed emm1 isolates throughout China constituted distinct clades, enriched by the presence of mobile genetic elements carrying the multidrug-resistant determinants ermB and tetM and virulence genes speA, speC, and spd1. Conclusion: A significant increase in the proportion ofemm1 strains occurred in the GAS population, causing scarlet fever in China. Ongoing surveillance is warranted to monitor the dynamic changes of GAS clones.