Volume 29, Number 10—October 2023
Dispatch
Expansion of Invasive Group A Streptococcus M1UK Lineage in Active Bacterial Core Surveillance, United States, 2019‒2021
Yuan Li
, Joy Rivers, Saundra Mathis, Zhongya Li, Sopio Chochua, Benjamin J. Metcalf, Bernard Beall, Jennifer Onukwube, Christopher J. Gregory, and Lesley McGee
, Joy Rivers, Saundra Mathis, Zhongya Li, Sopio Chochua, Benjamin J. Metcalf, Bernard Beall, Jennifer Onukwube, Christopher J. Gregory, and Lesley McGee
Table
Strain and patient features of M1UK iGAS compared with other M1 iGAS in ABCs, United States, 2015–2021
| Characteristic | M1 iGAS, no. (%) cases |
p value† | |
|---|---|---|---|
| M1UK, n = 86 | Non-M1UK, n = 1,747 | ||
| Strain feature‡ | |||
| Antimicrobial susceptibility | |||
| Penicillin nonsusceptible | 0 | 0 | 1.000 |
| Erythromycin nonsusceptible | 0 | 21 (1.2) | 0.621 |
| Clindamycin nonsusceptible | 0 | 20 (1.1) | 1.000 |
| Tetracycline nonsusceptible | 0 | 18 (1) | 1.000 |
| Levofloxacin nonsusceptible |
0 |
9 (0.5) |
1.000 |
| Pyrogenic exotoxin genes | |||
| speA | 86 (100) | 1,720 (98.5) | 0.635 |
| speC | 4 (4.7) | 24 (1.4) | 0.039 |
| speG | 86 (100) | 1747 (100) | 1.000 |
| speH | 0 | 1 (0.1) | 1.000 |
| speI | 0 | 1 (0.1) | 1.000 |
| speJ | 86 (100) | 1,747 (100) | 1.000 |
| speK | 0 | 2 (0.1) | 1.000 |
| speL | 0 | 0 | 1.000 |
| speM | 0 | 0 | 1.000 |
| Ssa | 2 (2.3) | 2 (0.1) | 0.012 |
| smeZ |
85 (98.8) |
1,737 (99.4) |
0.411 |
| Other virulence factors | |||
| hasA hyaluronic acid synthetase, capsule | 86 (100) | 1,03 (97.5) | 0.266 |
| Virulence-associated DNase, SDA1§ |
86 (100) |
1,613 (92.3) |
0.002 |
| Patient characteristic | |||
| Age, y | |||
| <18 | 12 (14) | 233 (13.3) | 0.871 |
| 18–34 | 5 (5.8) | 178 (10.2) | 0.266 |
| 35–49 | 19 (22.1) | 333 (19.1) | 0.484 |
| 50–64 | 21 (24.4) | 445 (25.5) | 0.899 |
| 65–74 | 15 (17.4) | 289 (16.5) | 0.768 |
| >75 | 14 (16.3) | 269 (15.4) | 0.762 |
| Sex | |||
| M | 41 (47.7) | 955 (54.7) | 0.223 |
| F |
45 (52.3) |
792 (45.3) |
0.223 |
| Clinical syndrome | |||
| Cellulitis | 25 (29.1) | 633 (36.2) | 0.205 |
| Bacteremia without focus | 11 (12.8) | 276 (15.8) | 0.544 |
| Pneumonia | 28 (32.6) | 384 (22.0) | 0.033 |
| Necrotizing fasciitis | 5 (5.8) | 147 (8.4) | 0.546 |
| Streptococcal toxic shock syndrome | 7 (8.1) | 95 (5.4) | 0.328 |
| Death | 19 (22.1) | 260 (14.9) | 0.089 |
*ABCs, Active Bacterial Core Surveillance System; iGAS, invasive group A Streptococcus disease. †By Fisher exact test. ‡All strain features, including antimicrobial susceptibility, pyrogenic exotoxin genes, and other virulence factors, were inferred from whole-genome sequencing data. §Detecting genetic marker for the sda1 gene (GenBank accession no. AY452036.1), which is identical to the sdaD2 gene (M5005_Spy1415; GenBank accession no. AAZ52033.1).
Page created: August 18, 2023
Page updated: September 20, 2023
Page reviewed: September 20, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.