Group A streptococcal meningitis with the M1UK variant in the Netherlands
van der Putten, B. C.; Vlaminckx, B. J.; de Gier, B.; Freudenburg-de Graaf, W.; van Sorge, N. M.
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We analyzed over 40 years of bacteriological surveillance data to reveal a 4-fold increase in Group A streptococcal (GAS) meningitis in 2022 compared to the annual average of 1982-2021 (n=5/year). Already 10 GAS meningitis cases occurred in 2023 (until March 13th). Molecular typing revealed that 25 out-of-29 (86%) isolates received in 2022 and 2023 were emm1.0 (Figure 1). WGS analysis of 19 emm1.0 isolates (2019 until 20th December 2022) demonstrated that 15 out-of-19 (79%) isolates belonged to the toxicogenic M1UK lineage. Based on these observations, we urge clinicians to be vigilant regarding clinical sign of meningitis with invasive GAS infections, since this disease manifestation appears to have a higher than expected occurrence due to clonal replacement by the recently-emerged M1UK variant. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=143 SRC="FIGDIR/small/23286423v3_fig1.gif" ALT="Figure 1"> View larger version (21K): org.highwire.dtl.DTLVardef@12ea749org.highwire.dtl.DTLVardef@1e8c4e6org.highwire.dtl.DTLVardef@d6dd1forg.highwire.dtl.DTLVardef@4f26dc_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOFigure 1.C_FLOATNO Number of received S. pyogenes CSF isolates with proportion of emm1.0, 2013-2023 (until March 13th). C_FIG
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