Characterization of a Community Cluster of Group a Streptococcal Invasive Disease in Maui, Hawaii

Erdem, Güliz; Abe, Lucienne; Kanenaka, R.; Pang, Lorrin; Mills, Kristin M.; Mizumoto, C. Y.; Yamaga, Karen; Effler, Paul V.

doi:10.1097/01.inf.0000130956.47691.99

Cited by 9 publications

(10 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, it can be hypothesized that the epidemic emm74 clone has recently been introduced to Canada from elsewhere. Although rare in North America and Europe, emm74 iGAS disease, including clusters of emm74 infections, has been described in Africa, India, New Zealand, New Caledonia, and Hawaii [8, 20, 40, 43–46]. We were unable to obtain isolates or genomic data for emm74 organisms isolated in these other geographic locations to test this hypothesis.…”

Section: Discussionmentioning

confidence: 96%

Canada-Wide Epidemic of emm74 Group A Streptococcus Invasive Disease

Teatero

McGeer

Tyrrell

et al. 2018

Open Forum Infectious Diseases

View full text Add to dashboard Cite

BackgroundThe number of invasive group A Streptococcus (iGAS) infections due to hitherto extremely rare type emm74 strains has increased in several Canadian provinces since late 2015. We hypothesized that the cases recorded in the different provinces are linked and caused by strains of an emm74 clone that recently emerged and expanded explosively.MethodsWe analyzed both active and passive surveillance data for iGAS infections and used whole-genome sequencing to investigate the phylogenetic relationships of the emm74 strains responsible for these invasive infections country-wide.ResultsGenome analysis showed that highly clonal emm74 strains, genetically different from emm74 organisms previously circulating in Canada, were responsible for a country-wide epidemic of >160 invasive disease cases. The emerging clone belonged to multilocus sequence typing ST120. The analysis also revealed dissemination patterns of emm74 subclonal lineages across Canadian provinces. Clinical data analysis indicated that the emm74 epidemic disproportionally affected middle-aged or older male individuals. Homelessness, alcohol abuse, and intravenous drug usage were significantly associated with invasive emm74 infections.ConclusionsIn a period of 20 months, an emm74 GAS clone emerged and rapidly spread across several Canadian provinces located more than 4500 km apart, causing invasive infections primarily among disadvantaged persons.

show abstract

Section: Discussionmentioning

confidence: 96%

Canada-Wide Epidemic of emm74 Group A Streptococcus Invasive Disease

Teatero

McGeer

Tyrrell

et al. 2018

Open Forum Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…These earlier studies were done in limited number of isolates (< 150 isolates) collected during and following two community-associated necrotizing fasciitis clusters (3, 4). In the current report, we determined the GAS emm types in a larger sample of isolates collected over a period of six years and examined the association between the specific/unique GAS types and clinical manifestations in Hawaii.…”

Section: Introductionmentioning

confidence: 99%

Streptococcal emm Types in Hawaii

Erdem

Mizumoto²,

Esaki³

et al. 2009

Pediatric Infectious Disease Journal

Self Cite

View full text Add to dashboard Cite

show abstract

“…The epidemiology of group A streptococcal (GAS) infections in Hawaii is unusual for the United States, with no seasonal differences in pharyngitis and impetigo rates (2,9,24). More important, the incidence rates for sequelae of GAS infections, such as acute rheumatic fever, have remained high (incidence of 9.5 to 12.4/100,000 persons/year) among Hawaiian and Polynesian ethnic groups (14).…”

mentioning

confidence: 99%