The emm-cluster typing system for Group A Streptococcus identifies epidemiologic similarities across the Pacific region

The emm-cluster typing system for Group A Streptococcus identifies epidemiologic similarities across the Pacific region

Group A Streptococcus (GAS)-related disease is responsible for high mortality and morbidity in the Pacific region. The high diversity of circulating strains in this region has hindered vaccine development due to apparently low vaccine coverage of type-specific vaccines. Prospective passive surveilla...

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Bibliographic Details
Published in:Clinical infectious diseases Vol. 59; no. 7; pp. e84 - e92
Main Authors: Baroux, Noémie, D'Ortenzio, Eric, Amédéo, Nathalie, Baker, Ciara, Ali Alsuwayyid, Barakat, Dupont-Rouzeyrol, Myrielle, O'Connor, Olivia, Steer, Andrew, Smeesters, Pierre R
Format: Journal Article
Language:English
Published: United States Oxford University Press 01-10-2014
Oxford University Press (OUP)
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antigens, Bacterial - genetics
Bacterial Outer Membrane Proteins - genetics
Biochemistry, Molecular Biology
Carrier Proteins - genetics
Child
Child, Preschool
Cluster Analysis
Epidemiology
Female
Humans
Infant
Infant, Newborn
International comparisons
Life Sciences
Male
Middle Aged
Molecular Epidemiology
Molecular Typing
Mortality
New Caledonia - epidemiology
Prospective Studies
Streptococcal Infections - epidemiology
Streptococcal Infections - microbiology
Streptococcus infections
Streptococcus pyogenes - classification
Streptococcus pyogenes - genetics
Streptococcus pyogenes - isolation & purification
Vaccines
Young Adult
New Caledonia
Australia
Fiji
typing
Streptococcus pyogenes
vaccine
emm cluster
invasive diseases
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Summary:Group A Streptococcus (GAS)-related disease is responsible for high mortality and morbidity in the Pacific region. The high diversity of circulating strains in this region has hindered vaccine development due to apparently low vaccine coverage of type-specific vaccines. Prospective passive surveillance of all GAS isolates in New Caledonia was undertaken in 2012 using emm typing and emm-cluster typing. Molecular data were compared with the results from a prior study undertaken in the same country and with data from 2 other Pacific countries, Fiji and Australia. A high incidence of invasive infection was demonstrated at 43 cases per 100 000 inhabitants (95% confidence interval, 35-52 cases per 100 000 inhabitants). Three hundred eighteen GAS isolates belonging to 47 different emm types were collected. In Noumea, only 30% of the isolates recovered in 2012 belonged to an emm type that was present in the same city in 2006, whereas 69% of the isolates collected in 2012 belonged to an emm cluster present in 2006. When comparing New Caledonian, Australian, and Fijian data, very few common emm types were found, but 79%-86% of the isolates from each country belonged to an emm cluster present in all 3 countries. A vaccine that could protect against the 10 most frequent emm clusters in the Pacific region would potentially provide coverage ranging from 83% to 92%. This study confirms the high disease burden of GAS infection in New Caledonia and supports the added value of the emm-cluster typing system to analyze GAS epidemiology and to help inform global GAS vaccine formulation.
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ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciu490