TY - JOUR
T1 - Outbreak of Streptococcus pyogenes emm89 ST646 in a head and neck surgical oncology ward
AU - Hayama, Brian
AU - Harada, Sohei
AU - Suzuki, Masahiro
AU - Doi, Yohei
AU - Nomura, Yusuke
AU - Aoki, Kotaro
AU - Takehana, Kazumi
AU - Akatsuchi, Tomomi
AU - Enokida, Taisuke
AU - Takeda, Koichi
AU - Seto, Akira
AU - Mitani, Hiroki
AU - Ohkushi, Daisuke
N1 - Publisher Copyright:
© 2024 American Society for Microbiology. All rights reserved.
PY - 2024/5
Y1 - 2024/5
N2 - Streptococcus pyogenes causes a variety of human infections, and hospital outbreaks with this pathogen have also been reported. The purpose of this study is to describe the clinical characteristics of an outbreak of S. pyogenes involving 15 patients and four healthcare workers (HCWs), as well as the molecular characteristics of the causative isolates. The course and response to the outbreak were reviewed, and information on the characteristics of the patients was extracted retrospectively from the medical records. Whole-genome sequencing of the 16 causative isolates (14 from patients and two from HCWs) was also performed. All 15 patients were postoperative of head and neck cancer with tracheotomy, and 12 had invasive infections, primarily surgical site infections, all of which resolved without causing serious illness. All but the first case was detected more than 7 days after admission. S. pyogenes was detected in two patients after empiric antimicrobial administration was performed on all inpatients and HCWs, and the outbreak was finally contained in approximately 2 months. All isolates detected in patients and HCWs belonged to emm89/clade 3, a hypervirulent clone that has emerged worldwide and was classified as sequence type 646. These isolates had single nucleotide polymorphism (SNP) differences of zero to one, indicating clonal transmission. This study demonstrated an outbreak of S. pyogenes emm89/clade 3 in a ward of patients with head and neck cancer. The global emergence of hypervirulent isolates may increase the risk of outbreaks among high-risk patients.
AB - Streptococcus pyogenes causes a variety of human infections, and hospital outbreaks with this pathogen have also been reported. The purpose of this study is to describe the clinical characteristics of an outbreak of S. pyogenes involving 15 patients and four healthcare workers (HCWs), as well as the molecular characteristics of the causative isolates. The course and response to the outbreak were reviewed, and information on the characteristics of the patients was extracted retrospectively from the medical records. Whole-genome sequencing of the 16 causative isolates (14 from patients and two from HCWs) was also performed. All 15 patients were postoperative of head and neck cancer with tracheotomy, and 12 had invasive infections, primarily surgical site infections, all of which resolved without causing serious illness. All but the first case was detected more than 7 days after admission. S. pyogenes was detected in two patients after empiric antimicrobial administration was performed on all inpatients and HCWs, and the outbreak was finally contained in approximately 2 months. All isolates detected in patients and HCWs belonged to emm89/clade 3, a hypervirulent clone that has emerged worldwide and was classified as sequence type 646. These isolates had single nucleotide polymorphism (SNP) differences of zero to one, indicating clonal transmission. This study demonstrated an outbreak of S. pyogenes emm89/clade 3 in a ward of patients with head and neck cancer. The global emergence of hypervirulent isolates may increase the risk of outbreaks among high-risk patients.
KW - ST646
KW - Streptococcus pyogenes
KW - emm89
KW - outbreak
UR - http://www.scopus.com/inward/record.url?scp=85192114258&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85192114258&partnerID=8YFLogxK
U2 - 10.1128/spectrum.04260-23
DO - 10.1128/spectrum.04260-23
M3 - Article
C2 - 38587390
AN - SCOPUS:85192114258
SN - 2165-0497
VL - 12
JO - Microbiology spectrum
JF - Microbiology spectrum
IS - 5
ER -