{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T13:38:10Z","timestamp":1774013890500,"version":"3.50.1"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000384","name":"Higher Education Funding Council for England","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000384","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000858","name":"University of Sheffield","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000858","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Wellcome Trust Intermediate Clinical"},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100022572","name":"Sheffield Biomedical Research Centre","doi-asserted-by":"publisher","award":["NIHR203321"],"award-info":[{"award-number":["NIHR203321"]}],"id":[{"id":"10.13039\/501100022572","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Streptococcus pyogenes\u2013related skin infections are increasingly implicated in the development of rheumatic heart disease (RHD) in lower-resource settings, where they are often associated with scabies. The true prevalence of S pyogenes\u2013related pyoderma may be underestimated by bacterial culture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multiplex quantitative polymerase chain reaction (qPCR) assay for S pyogenes, Staphylococcus aureus, and Sarcoptes scabiei was applied to 250 pyoderma swabs from a cross-sectional study of children aged &amp;lt;5 years in The Gambia. Direct PCR-based emm-typing was used to supplement previous whole genome sequencing (WGS) of cultured isolates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pyoderma lesions with S pyogenes increased from 51% (127\/250) using culture to 80% (199\/250) with qPCR. Compared to qPCR, the sensitivity of culture was 95.4% for S pyogenes (95% confidence interval {CI}, 77.2%\u201399.9%) in samples with S pyogenes alone (22\/250 [9%]), but 59.9% (95% CI, 52.3%\u201367.2%) for samples with S aureus coinfection (177\/250 [71%]). Direct PCR-based emm-typing was successful in 50% (46\/92) of cases, identifying 27 emm-types, including 6 not identified by WGS (total 52 emm-types).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Bacterial culture significantly underestimates the burden of S pyogenes in pyoderma, particularly with S aureus coinfection. Molecular methods should be used to enhance the detection of S pyogenes in surveillance studies and clinical trials of preventive measures in RHD-endemic settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiae359","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T19:53:13Z","timestamp":1720727593000},"page":"e28-e37","source":"Crossref","is-referenced-by-count":4,"title":["Molecular Methods Enhance the Detection of Pyoderma-Related\n                    <i>Streptococcus pyogenes<\/i>\n                    and\n                    <i>emm<\/i>\n                    -Type Distribution in Children"],"prefix":"10.1093","volume":"231","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2608-569X","authenticated-orcid":false,"given":"Jennifer N","family":"Hall","sequence":"first","affiliation":[{"name":"Division of Clinical Medicine and National Institute for Health and Care Research Sheffield Biomedical Research Centre, School of 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Unit The Gambia at The London School of Hygiene and Tropical Medicine , Banjul ,","place":["The Gambia"]},{"name":"Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine , London ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James S","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Peter Doherty Institute of Infection and Immunity, University of Melbourne , Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2642-9919","authenticated-orcid":false,"given":"Pierre","family":"Smeesters","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Brussels University Hospital, Academic Children Hospital Queen Fabiola, Universit\u00e9 libre de Bruxelles, Brussels, Belgium"},{"name":"Molecular Bacteriology Laboratory, Universit\u00e9 Libre de Bruxelles , Brussels ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4458-9748","authenticated-orcid":false,"given":"Claire E","family":"Turner","sequence":"additional","affiliation":[{"name":"The Florey Institute of Infection, University of Sheffield, Sheffield, United Kingdom"},{"name":"School of Biosciences, University of Sheffield , Sheffield ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2209-9956","authenticated-orcid":false,"given":"Thomas C","family":"Darton","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine and National Institute for Health and Care Research Sheffield Biomedical Research Centre, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom"},{"name":"The Florey Institute of Infection, University of Sheffield, Sheffield, United 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