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

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Chalker , Victoria J., Smith, Alyson, Al-Shahib, Ali, Botchway, Stella, Macdonald, Emily, Daniel, Roger, Phillips, Sarah, Platt, Steven, Doumith, Michel, Tewolde, Rediat, Coelho, Juliana, Jolley, Keith A., Underwood, Anthony and McCarthy, Noel D. (2016) Integration of genomic and other epidemiologic data to investigate and control a cross-institutional outbreak of Streptococcus pyogenes outbrea. Emerging Infectious Diseases , 22 (6). doi:10.3201/eid2206.142050 ISSN 1080-6059.

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Official URL: http://dx.doi.org/10.3201/eid2206.142050

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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.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Old age homes -- Health aspects -- Oxfordshire (England), Streptococcus pyogenes -- Prevention , Streptococcus pyogenes -- Genetic aspects, Streptococcus pyogenes -- Epidemiology
Journal or Publication Title: Emerging Infectious Diseases
Publisher: US Department of Health and Human Services
ISSN: 1080-6059
Official Date: June 2016
Dates:
DateEvent
June 2016Published
11 January 2016Accepted
Volume: 22
Number: 6
DOI: 10.3201/eid2206.142050
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Date of first compliant deposit: 1 June 2016
Date of first compliant Open Access: 1 June 2016
Funder: Public Health England
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