Novel emm4 lineage associated with an upsurge in invasive group A streptococcal disease in the Netherlands, 2022

• DOI: 10.1099/mgen.0.001026
• Publication Date: 2023-06-01T14:17:59Z
• Authors: Boas C.L. van der...; Wendy C.M. Bril-K...; Lidewij W. Rumke; Stefan M.T. Vestjens; Linda A.M. Koster; Marloes Willemsen; Marlies A. van Ho...; Nynke Y. Rots; Bart J.M. Vlaminckx; Brechje de Gier; Nina M. van Sorge
• Keywords: Lineage (genetic)

Invasive group A streptococcal (iGAS) disease cases increased in the first half of 2022 Netherlands, with a remarkably high proportion emm4 isolates. Whole-genome sequence analysis 66 isolates, 40 isolates from pre-coronavirus 2019 (COVID-19) pandemic period 2009-2019 and 26 contemporary 2022, identified novel Streptococcus pyogenes lineage (M4NL22), which accounted for 85 % iGAS 2022. Surprisingly, we detected few hypervirulent clone, has replaced nearly all other USA UK. M4NL22 displayed genetic differences compared to strains, although these were unclear biological significance. In publicly available data, single Norwegian isolate belonging M4NL22, was sampled after this study, possibly suggesting export Norway. conclusion, our study S. underlying an increase early Netherlands results have been promptly communicated public health officials.