Integration of genomic and other epidemiologic data to investigate and control a cross-institutional outbreak of Streptococcus pyogenes

Victoria Chalker, Alyson Smith, Ali Al-Shahib, Stella Botchway, Emily Macdonald, Roger Daniel, Sarah Phillips, Steven Platt, Michel Doumith, Rediat Tewolde, Juliana Coelho, Keith A. Jolley, Anthony Underwood, Noel D. McCarthy

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Single-strain outbreaks of Streptococcus pyogenes infections are common and often go undetected. In 2013, two clusters of invasive group A Streptococcus (iGAS) infection were identified in independent but closely located care homes in Oxfordshire, United Kingdom. Investigation included visits to each home, chart review, staff survey, microbiologic sampling, and genome sequencing. S. pyogenes emm type 1.0, the most common circulating type nationally, was identified from all cases yielding GAS isolates. A tailored whole-genome reference population comprising epidemiologically relevant contemporaneous isolates and published isolates was assembled. Data were analyzed independently using whole-genome multilocus sequencing and single-nucleotide polymorphism analyses. Six isolates from staff and residents of the homes formed a single cluster that was separated from the reference population by both analytical approaches. No further cases occurred after mass chemoprophylaxis and enhanced infection control. Our findings demonstrate the ability of 2 independent analytical approaches to enable robust conclusions from nonstandardized whole-genome analysis to support public health practice.

Original languageEnglish
Pages (from-to)973-980
Number of pages8
JournalEmerging Infectious Diseases
Volume22
Issue number6
DOIs
Publication statusPublished - Jun 2016

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