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A post-COVID-19 upsurge in Group A Streptococcus in the Czech Republic was driven by emm1 and emm12 with shared

Marek Stefan1, Suhanya Prasad2, Ivana Vitkova3

  • 1Department of Infectious Diseases and Travel Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.

Journal of Infection and Public Health
|July 10, 2025
PubMed
Abstract

Insights

Group A Streptococcus (GAS) infections surged in the Czech Republic in 2023, primarily driven by emm1 and emm12 strains. Factors like shared virulence genes and reduced immunity in children likely contributed to this increase.

Area of Science:

  • Microbiology
  • Epidemiology
  • Infectious Diseases

Background:

  • A notable rise in Streptococcus pyogenes (Group A Streptococcus - GAS) culture positivity was observed in Czech laboratories during 2023.
  • This prompted a multicentre study to investigate the epidemiology and characteristics of the circulating strains.

Purpose of the Study:

  • To analyze epidemiological data on GAS infections in the Czech Republic from 2017 to 2023.
  • To characterize the genetic and antimicrobial susceptibility profiles of prevalent GAS strains.

Main Methods:

  • Data from 11 microbiology departments on GAS-positive cultures from 2017-2023 were collected.
  • Whole-genome sequencing and antimicrobial susceptibility testing were performed on 120 GAS isolates from May 2023.

Main Results:

  • A statistically significant increase in GAS-positive cultures was recorded in 2023 compared to previous years, particularly affecting children.
  • The most common strains were emm1 (ST28) and emm12 (multiple STs), showing clonal clustering across regions.
  • Key virulence factors, including immune evasion (sic, sic-drs) and colonization (sda1) genes, were identified in emm1 and emm12 strains.

Conclusions:

  • The Czech Republic experienced an upsurge in GAS infections, predominantly caused by emm1 and emm12 strains.
  • A combination of shared virulence factors, altered herd immunity, and decreased immunity in children post-COVID-19 pandemic measures may explain the increased transmission.
Keywords:
Streptococcal inhibitor of complementStreptodornaseSurveillancedrs12.02 genesic gene

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