Group A Streptococcal Meningitis With the M1_UK Variant in the Netherlands

Abstract

This study reports an epidemiological assessment of laboratory-confirmed group A streptococcal meningitis cases in the Netherlands using more than 40 years of national bacteriological surveillance data.

Clinical and molecular epidemiological features of critically ill patients with invasive group A Streptococcus infections: a Belgian multicenter case-series

“…The M1 UK variant was first described in 2019 [ 20 ], has been associated with iGAS meningitis cases in the Netherlands [ 4 ], and seems to have become dominant in Belgium, as recently reported in the Netherlands and the UK [ 28 ]. This specific variant is characterized by 27 single nucleotide polymorphisms of which some have shown to increase the expression of exotoxin SpeA explaining its more toxigenic nature.…”

“…Risk factors for invasive group A streptococcal (iGAS) infection include extremes of age, diabetes, alcohol and intravenous drug use, but up to a third of cases occur in patients without comorbidities [ 2 ]. Also, circulation of specific virulent emm types in the community may impact severity and clinical presentation of iGAS infections [ 3 , 4 ]. Moreover, varicella zoster and influenza A viral infections have been associated with iGAS infections [ 2 , 5 , 6 ].…”

Group A Streptococcus strains causing meningitis without distinct invasive phenotype

“…A report from Switzerland described nine cases of GAS meningitis registered between 1983 and 1999 across all major Swiss hospitals, again emphasizing the rarity of this disease (Sommer et al, 1999 ). A recent report showed an increase in the number of GAS meningitis cases in the Netherlands in 2022–2023, compared with the previous 40 years, with emm‐1 being the most represented M‐protein variant (van der Putten et al, 2023 ).…”

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

“…Some 300 NZ isolates were included in the Global Atlas, 20 and whole-genome sequencing was applied to an outbreak of invasive GAS in an eldercare facility. 21 However, the population structure remains largely unexplored, including whether the strains of public health importance such as the M1 UK lineage that is associated with upsurges of scarlet fever and invasive GAS disease in the Northern hemisphere and Australia 22 , 23 , 24 is circulating in NZ. Here we describe genomic analysis of GAS isolates from a case-control study that investigated risk-factors for skin and throat infections in NZ school children.…”