{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:14:57Z","timestamp":1779927297406,"version":"3.53.1"},"reference-count":69,"publisher":"Microbiology Society","issue":"8","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["208765\/Z\/17\/Z"],"award-info":[{"award-number":["208765\/Z\/17\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["227240\/Z\/23\/Z"],"award-info":[{"award-number":["227240\/Z\/23\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,12]]},"abstract":"<jats:p>At the end of 2022 into early 2023, the UK Health Security Agency reported unusually high levels of scarlet fever and invasive disease caused by <jats:italic>Streptococcus pyogenes<\/jats:italic> (StrepA or group A <jats:italic>Streptococcus<\/jats:italic>). During this time, we collected and genome-sequenced 341 non-invasive throat and skin <jats:italic>S. pyogenes<\/jats:italic> isolates identified during routine clinical diagnostic testing in Sheffield, a large UK city. We compared the data with that obtained from a similar collection of 165 isolates from 2016 to 2017. Numbers of throat-associated isolates collected peaked in early December 2022, reflecting the national scarlet fever upsurge, while skin infections peaked later in December. The most common <jats:italic>emm<\/jats:italic>-types in 2022\u20132023 were <jats:italic>emm<\/jats:italic>1 (28.7\u200a%), <jats:italic>emm<\/jats:italic>12 (24.9\u200a%) and <jats:italic>emm<\/jats:italic>22 (7.7\u200a%) in throat and <jats:italic>emm<\/jats:italic>1 (22\u200a%), <jats:italic>emm<\/jats:italic>12 (10\u200a%), <jats:italic>emm<\/jats:italic>76 (18\u200a%) and <jats:italic>emm<\/jats:italic>49 (7\u200a%) in skin. While all <jats:italic>emm<\/jats:italic>1 isolates were the M1<jats:sub>UK<\/jats:sub> lineage, the comparison with 2016\u20132017 revealed diverse lineages in other <jats:italic>emm<\/jats:italic>-types, including <jats:italic>emm<\/jats:italic>12, and emergent lineages within other types including a new acapsular <jats:italic>emm<\/jats:italic>75 lineage, demonstrating that the upsurge was not completely driven by a single genotype. The analysis of the capsule locus predicted that only 51\u200a% of throat isolates would produce capsule compared with 78% of skin isolates. Ninety per cent of throat isolates were also predicted to have high NADase and streptolysin O (SLO) expression, based on the promoter sequence, compared with only 56% of skin isolates. Our study has highlighted the value in analysis of non-invasive isolates to characterize tissue tropisms, as well as changing strain diversity and emerging genomic features which may have implications for spillover into invasive disease and future <jats:italic>S. pyogenes<\/jats:italic> upsurges.<\/jats:p>","DOI":"10.1099\/mgen.0.001277","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T16:17:17Z","timestamp":1723479437000},"source":"Crossref","is-referenced-by-count":10,"title":["Molecular characterization of Streptococcus pyogenes (StrepA) non-invasive isolates during the 2022\u20132023 UK upsurge"],"prefix":"10.1099","volume":"10","author":[{"given":"Jennifer N.","family":"Hall","sequence":"first","affiliation":[{"name":"Medical Research Council Unit The Gambia at The London School of Hygiene and Tropical Medicine, Banjul, The Gambia"},{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, 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