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. 2016 Apr;22(4):734-8.
doi: 10.3201/eid2204.151582.

Hypervirulent emm59 Clone in Invasive Group A Streptococcus Outbreak, Southwestern United States

David M Engelthaler, Michael Valentine, Jolene Bowers, Jennifer Pistole, Elizabeth M Driebe, Joel Terriquez, Linus Nienstadt, Mark Carroll, Mare Schumacher, Mary Ellen Ormsby, Shane Brady, Eugene Livar, Del Yazzie, Victor Waddell, Marie Peoples, Kenneth Komatsu, Paul Keim

Hypervirulent emm59 Clone in Invasive Group A Streptococcus Outbreak, Southwestern United States

David M Engelthaler et al. Emerg Infect Dis. 2016 Apr.

Abstract

The hyper-virulent emm59 genotype of invasive group A Streptococcus was identified in northern Arizona in 2015. Eighteen isolates belonging to a genomic cluster grouped most closely with recently identified isolates in New Mexico. The continued transmission of emm59 in the southwestern United States poses a public health concern.

Keywords: Arizona; California; Canada; GAS; Minnesota; Native Americans; New Mexico; Oregon; bacteria; emm59; genomic epidemiology; group A Streptococcus; polytomy WGST; pyogenes; southwestern United States; streptococci.

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Figures

Figure 1
Figure 1
Phylogenetic single-nucleotide polymorphism (SNP) tree of emm59 isolates from a northern Arizona hospital displaying distribution of mutations in a 23kb positively selected region during invasive group A Streptococcus outbreak, southwestern United States. Maximum parsimony tree of all SNP loci (n = 58) in emm59 isolates (n = 18) from Arizona, 2 recent New Mexico isolate genomes, and the Canadian clone reference isolate MGAS15252. Consistency index = 1.0. Branch lengths represent numbers of SNPs between isolates; unit bar is in the figure. Numbered circles distinguish lineages of selected mutations in scpA, enn, sfbl, mga, sfbx, and sof genes in a 23-kb hotspot mutational region. Scale bar indicates SNPs.
Figure 2
Figure 2
Phylogenetic single-nucleotide polymorphism (SNP) tree of emm59 isolates from Arizona during invasive group A Streptococcus outbreak in the southwestern United States, previously analyzed US emm59 isolates, and the Canadian clone. Maximum parsimony tree of all 177 SNP loci (44 parsimony informative SNPs) in emm59 isolates from Arizona (n = 18), Minnesota (n = 29), Oregon (n = 8), New Mexico (N = 3), Colorado (n = 2), and California (n = 1) and the Canadian clone reference isolate MGAS15252. Tree has regions of recombination removed and is rooted with Minnesota isolate SRR11574570. Consistency index = 1.0. Numbers above branches are SNP distances. Scale bar indicates SNPs.
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