Longitudinal Analysis of Group A Streptococcus emm Types and emm Clusters in a High-Prevalence Setting: Relationship between Past and Future Infections

Author:

Campbell Patricia Therese12ORCID,Tong Steven Y C345,Geard Nicholas16,Davies Mark R7,Worthing Kate A7,Lacey Jake A4,Smeesters Pierre R28910,Batzloff Michael R11,Kado Joseph12131415,Jenney Adam W J1013,Mcvernon Jodie1216,Steer Andrew C21017

Affiliation:

1. Victorian Infectious Diseases Reference Laboratory Epidemiology Unit, The Peter Doherty Institute for Infection and Immunity, The Royal Melbourne Hospital and The University of Melbourne, Melbourne, Australia

2. Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne, Australia

3. Victorian Infectious Diseases Reference Laboratory Epidemiology Unit, The Royal Melbourne Hospital, Melbourne, Australia

4. Doherty Department at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia

5. Menzies School of Health Research, Charles Darwin University, Darwin, Australia

6. School of Computing and Information Systems, Melbourne School of Engineering, The University of Melbourne, Australia

7. Department of Microbiology and Immunology, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia

8. Molecular Bacteriology Laboratory, Université Libre de Bruxelles, Brussels, Belgium

9. Department of Pediatrics, Academic Children Hospital Queen Fabiola, Université Libre de Bruxelles, Brussels, Belgium

10. Centre for International Child Health, University of Melbourne, Melbourne, Australia

11. Institute for Glycomics, Gold Coast Campus, Griffith University, Australia

12. Department of Paediatrics, Colonial War Memorial Hospital, Suva, Fiji

13. College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji

14. Fiji Rheumatic Heart Disease Control Program, Suva, Fiji

15. Telethon Kids Institute, University of Western Australia, Perth, Australia

16. Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia

17. Department of Paediatrics, University of Melbourne, Royal Children’s Hospital Melbourne, Parkville, Australia

Abstract

Abstract Group A Streptococcus is a pathogen of global importance, but despite the ubiquity of group A Streptococcus infections, the relationship between infection, colonization, and immunity is still not completely understood. The M protein, encoded by the emm gene, is a major virulence factor and vaccine candidate and forms the basis of a number of classification systems. Longitudinal patterns of emm types collected from 457 Fijian schoolchildren over a 10-month period were analyzed. No evidence of tissue tropism was observed, and there was no apparent selective pressure or constraint of emm types. Patterns of emm type acquisition suggest limited, if any, modification of future infection based on infection history. Where impetigo is the dominant mode of transmission, circulating emm types either may not be constrained by ecological niches or population immunity to the M protein, or they may require several infections over a longer period of time to induce such immunity.

Funder

National Institute of Allergy and Infectious Diseases

Australian National Health and Medical Research Council

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Immunology and Allergy

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