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. 2023 Jun;28(26):2300291.
doi: 10.2807/1560-7917.ES.2023.28.26.2300291.

Increase in invasive group A streptococcal infections and emergence of novel, rapidly expanding sub-lineage of the virulent Streptococcus pyogenes M1 clone, Denmark, 2023

Thor Bech Johannesen  1 , Charlotte Munkstrup  2 , Sofie Marie Edslev  1 , Sharmin Baig  1 , Stine Nielsen  2 , Tjede Funk  2 , Dennis Karsten Kristensen  3 , Lars Hervig Jacobsen  3 , Signe Fischer Ravn  3 , Niels Bindslev  3 , Sophie Gubbels  3 , Marianne Voldstedlund  3 , Pikka Jokelainen  4 , Søren Hallstrøm  1 , Astrid Rasmussen  1 , Karl Gústaf Kristinsson  5   6 , David Fuglsang-Damgaard  7 , Ram B Dessau  8   9 , Agnieszka Barbara Olsén  10 , Christian Salgaard Jensen  11 , Annette Skovby  12 , Svend Ellermann-Eriksen  13 , Thøger Gorm Jensen  14 , Esad Dzajic  15 , Claus Østergaard  16 , Steen Lomborg Andersen  17 , Steen Hoffmann  1 , Peter Henrik Andersen  2 , Marc Stegger  18   1
Affiliations

Increase in invasive group A streptococcal infections and emergence of novel, rapidly expanding sub-lineage of the virulent Streptococcus pyogenes M1 clone, Denmark, 2023

Thor Bech Johannesen et al. Euro Surveill. 2023 Jun.

Abstract

A highly virulent sub-lineage of the Streptococcus pyogenes M1 clone has been rapidly expanding throughout Denmark since late 2022 and now accounts for 30% of the new invasive group A streptococcal infections. We aimed to investigate whether a shift in variant composition can account for the high incidence rates observed over winter 2022/23, or if these are better explained by the impact of COVID-19-related restrictions on population immunity and carriage of group A Streptococcus.

Keywords: Denmark; Iceland; M1; M1DK; Streptococcus pyogenes; bacterial genomics; group A Streptococcus; virulence.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Number of non-invasive (n = 86,793) and invasive (n = 1,265) laboratory-diagnosed infections of group A Streptococcus per 100,000 inhabitants per month, Denmark, January 2018–May 2023
Figure 2
Figure 2
Core genome phylogeny of all Streptococcus pyogenes M1 isolates sampled from invasive infections with available whole genome sequencing data, Denmark, January 2018–February 2023 (n = 251)
Figure 3
Figure 3
Distribution of variants in laboratory-diagnosed invasive group A streptococcal infections, Denmark, January 2018–February 2023 (n = 1,019)
See this image and copyright information in PMC

References

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