Population of invasive group A streptococci isolates from a German tertiary care center is dominated by the hypertoxigenic virulent M1UK genotype

Infection. 2024 Apr;52(2):667-671. doi: 10.1007/s15010-023-02137-1. Epub 2023 Dec 8.

Abstract

Purpose: Hypertoxigenic Streptococcus pyogenes emm1 lineage M1UK has recently been associated with upsurges of invasive infections and scarlet fever in several countries, but whole-genome sequencing surveillance data of lineages circulating in Germany is lacking. In this study, we investigated recent iGAS isolates from our laboratory at a German tertiary care center for the presence of the M1UK lineage.

Methods: Whole-genome sequencing was employed to characterize a collection of 47 consecutive non-copy isolates recovered from blood cultures (21) and tissue samples (26) in our laboratory between October 2022 and April 2023.

Results: M protein gene (emm) typing distinguished 14 different emm types, with emm1 (17) being the dominant type. Single-nucleotide polymorphism (SNP) analysis confirmed the presence of all 27 SNPs characteristic for the M1UK lineage in 14 of 17 emm1 isolates.

Conclusion: This study has shown for the first time that M1UK is present in Germany and might constitute a driving force in the observed surge of GAS infections. This observation mirrors developments in the UK and other countries and underscores the importance of WGS surveillance to understand the epidemiology of GAS.

Keywords: Emm type; Streptococcus pyogenes; Epidemiology; M1UK.

MeSH terms

  • Antigens, Bacterial / genetics
  • Bacterial Outer Membrane Proteins / genetics
  • Carrier Proteins
  • Genotype
  • Humans
  • Streptococcal Infections* / epidemiology
  • Streptococcus pyogenes* / genetics
  • Tertiary Care Centers
  • United Kingdom

Substances

  • Carrier Proteins
  • Antigens, Bacterial
  • Bacterial Outer Membrane Proteins