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

Author:

Johannesen Thor Bech1,Munkstrup Charlotte2,Edslev Sofie Marie1,Baig Sharmin1,Nielsen Stine2,Funk Tjede2,Kristensen Dennis Karsten3,Jacobsen Lars Hervig3,Ravn Signe Fischer3,Bindslev Niels3,Gubbels Sophie3,Voldstedlund Marianne3,Jokelainen Pikka4,Hallstrøm Søren1,Rasmussen Astrid1,Kristinsson Karl Gústaf56,Fuglsang-Damgaard David7,Dessau Ram B89,Olsén Agnieszka Barbara10,Jensen Christian Salgaard11,Skovby Annette12,Ellermann-Eriksen Svend13,Jensen Thøger Gorm14,Dzajic Esad15,Østergaard Claus16,Lomborg Andersen Steen17,Hoffmann Steen1,Andersen Peter Henrik2,Stegger Marc181

Affiliation:

1. Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark

2. Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark

3. Data Integration and Analysis, Statens Serum Institut, Copenhagen, Denmark

4. Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark

5. Faculty of Medicine, University of Iceland, Reykjavik, Iceland

6. Department of Clinical Microbiology, Landspitali – the National University Hospital, Reykjavik, Iceland

7. Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark

8. Department of Regional Health Research, University of Southern Denmark, Odense, Denmark

9. Department of Clinical Microbiology, Zealand University Hospital, Slagelse, Denmark

10. Department of Clinical Microbiology, Herlev and Gentofte Hospital – University Hospital, Herlev, Denmark

11. Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark

12. Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark

13. Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark

14. Department of Clinical Microbiology, Odense University Hospital and Research Unit of Clinical Microbiology, Odense, Denmark

15. Clinical Diagnostic Department, Clinical Microbiology, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark

16. Department of Clinical Microbiology, Lillebælt Hospital, University Hospital of Southern Denmark, Vejle, Denmark

17. Department of Clinical Microbiology, Sønderjylland Hospital, University Hospital of Southern Denmark, Aabenraa, Denmark

18. Antimicrobial Resistance and Infectious Diseases Laboratory, Harry Butler Institute, Murdoch University, Perth, Australia

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.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

Reference15 articles.

1. Increase in invasive group A streptococcal infection notifications, England, 2022.;Guy;Euro Surveill,2023

2. Increase in invasive group A streptococcal (Streptococcus pyogenes) infections (iGAS) in young children in the Netherlands, 2022.;de Gier;Euro Surveill,2023

3. World Health Organization Regional Office for Europe (WHO/Europe). Increase in invasive Group A streptococcal infections among children in Europe, including fatalities.  Copenhagen: WHO/Europe; 2022. Available from: https://www.who.int/europe/news/item/12-12-2022-increase-in-invasive-group-a-streptococcal-infections-among-children-in-europe--including-fatalities

4. The Danish Microbiology Database (MiBa) 2010 to 2013.;Voldstedlund;Euro Surveill,2014

5. Statistics Denmark (DST). Population figures. Copenhagen: DST. [Accessed: 8 Jun 2023]. Available from: https://www.dst.dk /

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