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Whole Genome Sequencing Analysis of Group A Streptococcus Isolates From Pediatric Patients in Korea From 2013 to 2024
Sungbin An1, Sun Ju Kim2, Jong Hyun Shin3
1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Background:
Group A Streptococcus (GAS) infections are a significant global health concern. A novel lineage of emm 1 strain (M1UK), responsible for invasive GAS (iGAS) infections, which are potentially life-threatening, has been reported globally since 2019. Recent epidemiological studies on GAS using whole genome sequencing (WGS) revealed its usefulness for surveillance of transmission of GAS.
Methods:
WGS analysis was performed using DNA extracted from cultured GAS isolates stored from 2013 to 2024 at a single center. Clinical data from patients with GAS infection were also analyzed.
Results:
Fifteen GAS isolates were collected from 12 pediatric patients (median age 4 years, 41.6% male). In patients with iGAS infection, emm 1 (n = 3), emm 12 (n = 4), and emm 89 (n = 1) were identified. In patients with non-iGAS infection, emm 1 (n = 1), emm 4 (n = 1), emm 12 (n = 1), and emm 28 (n = 1) were identified. Phylogenetic analysis and single-nucleotide polymorphism pattern comparison revealed that all emm 1 strains corresponded to M1global rather than M1UK. Three patients (two iGAS and one non-iGAS) had isolates from two different sites, for which the emm type was the same.
Conclusion:
Continuous surveillance of GAS strains is necessary to monitor and respond to the introduction of toxic variants such as M1UK.
Insights
Group A Streptococcus (GAS) infections, including invasive GAS (iGAS), pose a global health threat. Whole genome sequencing (WGS) of GAS isolates confirmed strains were M1global, not the concerning M1UK variant, highlighting the need for ongoing surveillance.
Area of Science:
- Microbiology
- Genomics
- Epidemiology
Background:
- Group A Streptococcus (GAS) infections represent a significant global health challenge.
- A novel lineage of emm 1 strain, M1UK, has been linked to invasive GAS (iGAS) infections since 2019.
- Whole genome sequencing (WGS) is a valuable tool for tracking GAS transmission.
Purpose of the Study:
- To analyze GAS isolates using WGS.
- To identify the emm types of GAS isolates.
- To determine if the M1UK lineage was present in the analyzed isolates.
Main Methods:
- WGS analysis of DNA from cultured GAS isolates (2013-2024).
- Analysis of clinical data from GAS-infected patients.
- Phylogenetic analysis and single-nucleotide polymorphism comparison.
Main Results:
- Fifteen GAS isolates from 12 pediatric patients were analyzed.
- emm 1, 12, 89, 4, and 28 were identified across invasive and non-invasive GAS infections.
- All identified emm 1 strains belonged to the M1global lineage, not the M1UK variant.
Conclusions:
- Continuous surveillance of GAS is crucial.
- Monitoring for emerging virulent GAS strains, like M1UK, is essential.
- WGS aids in identifying and tracking GAS strains effectively.
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