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Searching for Strep A in the clinical environment during a human challenge trial: a sub-study protocol
Stephanie L Enkel1,2, Thel K Hla1,2,3, Bernadette Wong1
1Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia.
Abstract:
Streptococcus pyogenes (also known as group A Streptococcus , Strep A) is an obligate human pathogen with significant global morbidity and mortality. Transmission is believed to occur primarily between individuals via respiratory droplets, but knowledge about other potential sources of transmission via aerosols or the environment is limited. Such knowledge is required to design optimal interventions to control transmission, particularly in endemic settings. We aim to detail an experimental methodology to assess the transmission potential of Strep A in a clinical environment. We will examine potential sources of transmission in up to 20 participants recruited to the Controlled human infection for penicillin against Streptococcus pyogenes (CHIPS) Trial. Three approaches to understanding transmission will be used: the use of selective agar settle plates to capture possible droplet or airborne spread of Strep A; measurement of the possible distance of Strep A droplet spread during conversation; and environmental swabbing of personal and common high-touch items to detect the presence of Strep A on hard and soft surfaces. All methods are designed to allow for an assessment of transmission potential by symptomatic, asymptomatic and non-cases. Ethical approval has been obtained through Bellberry Human Research Ethics Committee (approval 2021-03-295). Trial registration number: ACTRN12621000751875. Any results elicited from these experiments will be of benefit to the scientific literature in improving our knowledge of opportunities to prevent Strep A transmission as a direct component of the primordial prevention of rheumatic fever. Findings will be reported at local, national and international conferences and in peer-reviewed journals.
Insights
This study investigates how Streptococcus pyogenes (Strep A) spreads in clinical settings. Researchers used agar plates, droplet spread measurements, and environmental swabs to assess transmission routes for better control strategies.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Streptococcus pyogenes (Strep A) causes significant global health issues.
- Current understanding of Strep A transmission is limited, especially regarding environmental and aerosol routes.
- Effective control strategies require detailed knowledge of all transmission pathways.
Purpose of the Study:
- To develop and detail an experimental methodology for assessing Strep A transmission potential in a clinical environment.
- To investigate potential transmission sources including airborne, droplet, and surface contamination.
- To inform interventions for controlling Strep A spread, particularly in endemic regions.
Main Methods:
- Utilizing selective agar settle plates to detect airborne and droplet Strep A.
- Measuring the distance of Strep A droplet spread during conversational speech.
- Conducting environmental swabbing of high-touch surfaces (personal and common) to detect Strep A presence.
Main Results:
- The methodology allows for assessing transmission potential from symptomatic, asymptomatic, and non-cases.
- Data on airborne, droplet, and surface contamination will be collected.
- This research will quantify transmission risks in a controlled clinical setting.
Conclusions:
- The developed methodology provides a comprehensive approach to understanding Strep A transmission dynamics.
- Findings will enhance knowledge of Strep A transmission opportunities, aiding in rheumatic fever prevention.
- Results will be disseminated through scientific publications and conferences.
