{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:12:29Z","timestamp":1788261149578,"version":"build-2803163510"},"reference-count":50,"publisher":"Centers for Disease Control and Prevention (CDC)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Emerg. Infect. Dis."],"published-print":{"date-parts":[[2023,5]]},"DOI":"10.3201\/eid2905.221421","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T21:48:07Z","timestamp":1682372887000},"source":"Crossref","is-referenced-by-count":25,"title":["Emergence of Erythromycin-Resistant Invasive Group A <i>Streptococcus<\/i>, West Virginia, USA, 2020\u20132021"],"prefix":"10.3201","volume":"29","author":[{"given":"Lillie M.","family":"Powell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Jeon","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe E.","family":"Chipman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan E.","family":"Grund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Rocco","family":"LaSala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Slawomir","family":"Lukomski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1822","reference":[{"key":"key-10.3201\/eid2905.221421-202304241738-R1","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1093\/clinids\/14.1.2","article-title":"Invasive group A streptococcus infections.","volume":"14","author":"Stevens","year":"1992","journal-title":"Clin Infect Dis"},{"key":"key-10.3201\/eid2905.221421-202304241738-R2","doi-asserted-by":"publisher","first-page":"15084","DOI":"10.1038\/nrdp.2015.84","article-title":"Acute rheumatic fever and rheumatic heart disease.","volume":"2","author":"Carapetis","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"key-10.3201\/eid2905.221421-202304241738-R3","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1128\/CMR.00101-13","article-title":"Disease manifestations and pathogenic mechanisms of Group A Streptococcus.","volume":"27","author":"Walker","year":"2014","journal-title":"Clin Microbiol Rev"},{"key":"key-10.3201\/eid2905.221421-202304241738-R4","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1586\/14787210.2015.1023292","article-title":"Macrolide-resistant Streptococcus pyogenes: prevalence and treatment strategies.","volume":"13","author":"Silva-Costa","year":"2015","journal-title":"Expert Rev Anti Infect Ther"},{"key":"key-10.3201\/eid2905.221421-202304241738-R5","doi-asserted-by":"publisher","first-page":"e000316","DOI":"10.1099\/mgen.0.000316","article-title":"Unexpected relationships between frequency of antimicrobial resistance, disease phenotype and emm type in group A Streptococcus.","volume":"5","author":"Sanson","year":"2019","journal-title":"Microb Genom"},{"key":"key-10.3201\/eid2905.221421-202304241738-R6","doi-asserted-by":"publisher","first-page":"5886","DOI":"10.1128\/AAC.03638-14","article-title":"Tn5253 family integrative and conjugative elements carrying mef(I) and catQ determinants in Streptococcus pneumoniae and Streptococcus pyogenes.","volume":"58","author":"Mingoia","year":"2014","journal-title":"Antimicrob Agents Chemother"},{"key":"key-10.3201\/eid2905.221421-202304241738-R7","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1016\/j.ijantimicag.2019.08.019","article-title":"A novel genomic island harbouring lsa(E) and lnu(B) genes and a defective prophage in a Streptococcus pyogenes isolate resistant to lincosamide, streptogramin A and pleuromutilin antibiotics.","volume":"54","author":"Berbel","year":"2019","journal-title":"Int J Antimicrob Agents"},{"key":"key-10.3201\/eid2905.221421-202304241738-R8","unstructured":"Centers for Disease Control and Prevention. Erythromycin-resistant group A Streptococcus [cited 2021 Nov 23]. https:\/\/www.cdc.gov\/drugresistance\/pdf\/threats-report\/gas-508.pdf"},{"key":"key-10.3201\/eid2905.221421-202304241738-R9","unstructured":"Centers for Disease Control and Prevention. Active Bacterial Core Surveillance (ABCs): Emerging Infections Program network, group A Streptococcus, 2010 [cited 2012 Jan 5]. https:\/\/www.cdc.gov\/abcs\/reports-findings\/survreports\/gas10.html"},{"key":"key-10.3201\/eid2905.221421-202304241738-R10","unstructured":"Centers for Disease Control and Prevention. Active Bacterial Core Surveillance Report: Emerging Infections Program network, group A Streptococcus, 2019 [cited 2022 Jun 16]. https:\/\/www.cdc.gov\/abcs\/downloads\/GAS_Surveillance_Report_2019.pdf"},{"key":"key-10.3201\/eid2905.221421-202304241738-R11","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1093\/cid\/ciab575","article-title":"Patterns of antibiotic nonsusceptibility among invasive group A Streptococcus infections\u2014United States, 2006\u20132017.","volume":"73","author":"Fay","year":"2021","journal-title":"Clin Infect Dis"},{"key":"key-10.3201\/eid2905.221421-202304241738-R12","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1093\/cid\/ciaa027","article-title":"Risk factors and predictors of mortality in streptococcal necrotizing soft-tissue infections: a multicenter prospective study.","volume":"72","author":"Bruun","year":"2021","journal-title":"Clin Infect Dis"},{"key":"key-10.3201\/eid2905.221421-202304241738-R13","unstructured":"Centers for Disease Control and Prevention. 2020 drug overdose death rates [cited 2022 Jul 27]. https:\/\/www.cdc.gov\/drugoverdose\/deaths\/2020.html"},{"key":"key-10.3201\/eid2905.221421-202304241738-R14","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1101\/gr.4.6.368","article-title":"A simple \u201cuniversal\u201d DNA extraction procedure using SDS and proteinase K is compatible with direct PCR amplification.","volume":"4","author":"Goldenberger","year":"1995","journal-title":"PCR Methods Appl"},{"key":"key-10.3201\/eid2905.221421-202304241738-R15","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1128\/AAC.01352-07","article-title":"Plasmid-Borne erm(T) from invasive, macrolide-resistant Streptococcus pyogenes strains.","volume":"52","author":"Woodbury","year":"2008","journal-title":"Antimicrob Agents Chemother"},{"key":"key-10.3201\/eid2905.221421-202304241738-R16","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1128\/jcm.34.4.953-958.1996","article-title":"Sequencing emm-specific PCR products for routine and accurate typing of group A streptococci.","volume":"34","author":"Beall","year":"1996","journal-title":"J Clin Microbiol"},{"key":"key-10.3201\/eid2905.221421-202304241738-R17","unstructured":"Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. 31st ed. CLSI supplement M100. Wayne (PA): The Institute; 2021."},{"key":"key-10.3201\/eid2905.221421-202304241738-R18","doi-asserted-by":"publisher","first-page":"2668","DOI":"10.1073\/pnas.88.7.2668","article-title":"Streptococcus pyogenes causing toxic-shock-like syndrome and other invasive diseases: clonal diversity and pyrogenic exotoxin expression.","volume":"88","author":"Musser","year":"1991","journal-title":"Proc Natl Acad Sci U S A"},{"key":"key-10.3201\/eid2905.221421-202304241738-R19","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1093\/infdis\/jiz195","article-title":"A mobile genetic element promotes the association between serotype M28 group A Streptococcus isolates and cases of puerperal sepsis.","volume":"220","author":"Jain","year":"2019","journal-title":"J Infect Dis"},{"key":"key-10.3201\/eid2905.221421-202304241738-R20","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1128\/AAC.01065-08","article-title":"Characterization of macrolide efflux pump mef subclasses detected in clinical isolates of Streptococcus pyogenes isolated between 1999 and 2005.","volume":"53","author":"Blackman Northwood","year":"2009","journal-title":"Antimicrob Agents Chemother"},{"key":"key-10.3201\/eid2905.221421-202304241738-R21","doi-asserted-by":"publisher","first-page":"2844","DOI":"10.1128\/AAC.47.9.2844-2849.2003","article-title":"Presence of the tet(O) gene in erythromycin- and tetracycline-resistant strains of Streptococcus pyogenes and linkage with either the mef(A) or the erm(A) gene.","volume":"47","author":"Giovanetti","year":"2003","journal-title":"Antimicrob Agents Chemother"},{"key":"key-10.3201\/eid2905.221421-202304241738-R22","doi-asserted-by":"publisher","first-page":"e3718","DOI":"10.1093\/cid\/ciaa787","article-title":"Invasive group A streptococcal infections among people who inject drugs and people experiencing homelessness in the United States, 2010\u20132017.","volume":"73","author":"Valenciano","year":"2021","journal-title":"Clin Infect Dis"},{"key":"key-10.3201\/eid2905.221421-202304241738-R23","doi-asserted-by":"publisher","first-page":"e01422","DOI":"10.1128\/mBio.01422-17","article-title":"Population and whole genome sequence based characterization of invasive group A streptococci recovered in the United States during 2015.","volume":"8","author":"Chochua","year":"2017","journal-title":"MBio"},{"key":"key-10.3201\/eid2905.221421-202304241738-R24","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.3389\/fmicb.2020.01547","article-title":"Genomic surveillance of Streptococcus pyogenes strains causing invasive disease, United States, 2016\u20132017.","volume":"11","author":"Li","year":"2020","journal-title":"Front Microbiol"},{"key":"key-10.3201\/eid2905.221421-202304241738-R25","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1128\/JCM.01205-09","article-title":"Clinical and microbial characteristics of invasive Streptococcus pyogenes disease in New Caledonia, a region in Oceania with a high incidence of acute rheumatic fever.","volume":"48","author":"Le Hello","year":"2010","journal-title":"J Clin Microbiol"},{"key":"key-10.3201\/eid2905.221421-202304241738-R26","doi-asserted-by":"publisher","first-page":"679","DOI":"10.3855\/jidc.9132","article-title":"Molecular epidemiology of macrolide resistant Group A streptococci from Puducherry, India.","volume":"11","author":"Abraham","year":"2017","journal-title":"J Infect Dev Ctries"},{"key":"key-10.3201\/eid2905.221421-202304241738-R27","doi-asserted-by":"publisher","first-page":"8175","DOI":"10.1016\/j.vaccine.2011.09.005","article-title":"New 30-valent M protein-based vaccine evokes cross-opsonic antibodies against non-vaccine serotypes of group A streptococci.","volume":"29","author":"Dale","year":"2011","journal-title":"Vaccine"},{"key":"key-10.3201\/eid2905.221421-202304241738-R28","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1093\/jac\/dks352","article-title":"Interspecies mobilization of an ermT-carrying plasmid of Streptococcus dysgalactiae subsp. equisimilis by a coresident ICE of the ICESa2603 family.","volume":"68","author":"Palmieri","year":"2013","journal-title":"J Antimicrob Chemother"},{"key":"key-10.3201\/eid2905.221421-202304241738-R29","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1128\/AAC.01091-09","article-title":"Identification of a plasmid-borne resistance gene cluster comprising the resistance genes erm(T), dfrK, and tet(L) in a porcine methicillin-resistant Staphylococcus aureus ST398 strain.","volume":"54","author":"Kadlec","year":"2010","journal-title":"Antimicrob Agents Chemother"},{"key":"key-10.3201\/eid2905.221421-202304241738-R30","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.diagmicrobio.2011.07.010","article-title":"Identification and characterization of plasmid-borne erm(T) macrolide resistance in group B and group A Streptococcus.","volume":"71","author":"DiPersio","year":"2011","journal-title":"Diagn Microbiol Infect Dis"},{"key":"key-10.3201\/eid2905.221421-202304241738-R31","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1089\/mdr.2016.0129","article-title":"Molecular characteristics of erythromycin-resistant Streptococcus pyogenes strains isolated from children patients in Tunis, Tunisia.","volume":"23","author":"Ksia","year":"2017","journal-title":"Microb Drug Resist"},{"key":"key-10.3201\/eid2905.221421-202304241738-R32","doi-asserted-by":"publisher","first-page":"ofw243","DOI":"10.1093\/ofid\/ofw243","article-title":"High incidence of invasive group A streptococcal infections in remote indigenous communities in Northwestern Ontario, Canada.","volume":"4","author":"Bocking","year":"2016","journal-title":"Open Forum Infect Dis"},{"key":"key-10.3201\/eid2905.221421-202304241738-R33","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.jinf.2018.05.010","article-title":"Epidemiology of an upsurge of invasive group A streptococcal infections in Ireland, 2012-2015.","volume":"77","author":"Meehan","year":"2018","journal-title":"J Infect"},{"key":"key-10.3201\/eid2905.221421-202304241738-R34","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1099\/jmm.0.000460","article-title":"Characterisation of clinically isolated Streptococcus pyogenes from balanoposthitis patients, with special emphasis on emm89 isolates.","volume":"66","author":"Hasegawa","year":"2017","journal-title":"J Med Microbiol"},{"key":"key-10.3201\/eid2905.221421-202304241738-R35","doi-asserted-by":"publisher","first-page":"542","DOI":"10.3389\/fmicb.2018.00542","article-title":"Identification and characterization of fluoroquinolone non-susceptible Streptococcus pyogenes clones harboring tetracycline and macrolide resistance in Shanghai, China.","volume":"9","author":"Shen","year":"2018","journal-title":"Front Microbiol"},{"key":"key-10.3201\/eid2905.221421-202304241738-R36","doi-asserted-by":"publisher","first-page":"e01378","DOI":"10.1128\/mBio.01378-15","article-title":"Trading capsule for increased cytotoxin production: contribution to virulence of a newly emerged clade of emm89 Streptococcus pyogenes.","volume":"6","author":"Zhu","year":"2015","journal-title":"MBio"},{"key":"key-10.3201\/eid2905.221421-202304241738-R37","doi-asserted-by":"publisher","first-page":"e00622","DOI":"10.1128\/mBio.00622-15","article-title":"Emergence of a new highly successful acapsular group A Streptococcus clade of genotype emm89 in the United Kingdom.","volume":"6","author":"Turner","year":"2015","journal-title":"MBio"},{"key":"key-10.3201\/eid2905.221421-202304241738-R38","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1089\/mdr.2013.0213","article-title":"Prevalence of macrolide resistance among group A streptococci isolated from pharyngotonsillitis.","volume":"20","author":"Wajima","year":"2014","journal-title":"Microb Drug Resist"},{"key":"key-10.3201\/eid2905.221421-202304241738-R39","doi-asserted-by":"publisher","first-page":"e02521","DOI":"10.1128\/mBio.02521-19","article-title":"The emergence of successful Streptococcus pyogenes lineages through convergent pathways of capsule loss and recombination directing high toxin expression.","volume":"10","author":"Turner","year":"2019","journal-title":"MBio"},{"key":"key-10.3201\/eid2905.221421-202304241738-R40","doi-asserted-by":"publisher","first-page":"e0008022","DOI":"10.1128\/iai.00080-22","article-title":"The integrative conjugative element ICESpyM92 contributes to pathogenicity of emergent antimicrobial-resistant emm92 group A Streptococcus.","volume":"90","author":"Vega","year":"2022","journal-title":"Infect Immun"},{"key":"key-10.3201\/eid2905.221421-202304241738-R41","doi-asserted-by":"publisher","first-page":"e00088","DOI":"10.1128\/CMR.00088-17","article-title":"Mobile genetic elements associated with antimicrobial resistance.","volume":"31","author":"Partridge","year":"2018","journal-title":"Clin Microbiol Rev"},{"key":"key-10.3201\/eid2905.221421-202304241738-R42","doi-asserted-by":"publisher","first-page":"e0116254","DOI":"10.1371\/journal.pone.0116254","article-title":"Transcriptional attenuation controls macrolide inducible efflux and resistance in Streptococcus pneumoniae and in other Gram-positive bacteria containing mef\/mel(msr(D)) elements.","volume":"10","author":"Chancey","year":"2015","journal-title":"PLoS One"},{"key":"key-10.3201\/eid2905.221421-202304241738-R43","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1093\/infdis\/jiac162","article-title":"Cluster transmission drives invasive group A Streptococcus disease within the United States and is focused on communities experiencing disadvantage.","volume":"226","author":"Metcalf","year":"2022","journal-title":"J Infect Dis"},{"key":"key-10.3201\/eid2905.221421-202304241738-R44","article-title":"Continued increase of erythromycin- and clindamycin-nonsusceptibility among invasive group A streptococci driven by genomic clusters, USA, 2018\u20132019.","author":"Li","year":"2022","journal-title":"Clin Infect Dis"},{"key":"key-10.3201\/eid2905.221421-202304241738-R45","doi-asserted-by":"publisher","first-page":"e0080222","DOI":"10.1128\/aac.00802-22","article-title":"Invasive group A streptococcal penicillin binding protein 2\u00d7 variants associated with reduced susceptibility to \u03b2-lactam antibiotics in the United States, 2015\u20132021.","volume":"66","author":"Chochua","year":"2022","journal-title":"Antimicrob Agents Chemother"},{"key":"key-10.3201\/eid2905.221421-202304241738-R46","unstructured":"National Institute on Drug Abuse. West Virginia: opioid-involved deaths and related harms. 2020 [cited 2022 May 5]. https:\/\/nida.nih.gov\/drug-topics\/opioids\/opioid-summaries-by-state\/west-virginia-opioid-involved-deaths-related-harms"},{"key":"key-10.3201\/eid2905.221421-202304241738-R47","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1186\/s13011-021-00423-5","article-title":"The impact of the novel coronavirus disease (COVID-19) pandemic on drug overdose-related deaths in the United States and Canada: a systematic review of observational studies and analysis of public health surveillance data.","volume":"16","author":"Imtiaz","year":"2021","journal-title":"Subst Abuse Treat Prev Policy"},{"key":"key-10.3201\/eid2905.221421-202304241738-R48","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1136\/rapm-2022-103591","article-title":"Impact of the COVID-19 pandemic on opioid overdose and other adverse events in the USA and Canada: a systematic review.","volume":"48","author":"Simha","year":"2023","journal-title":"Reg Anesth Pain Med"},{"key":"key-10.3201\/eid2905.221421-202304241738-R49","doi-asserted-by":"publisher","first-page":"15589447221077377","DOI":"10.1177\/15589447221077377","article-title":"Upper extremity infection related to intravenous drug use: considering the true cost of the COVID-19 pandemic and lockdown.","author":"McRae","year":"2022","journal-title":"Hand (N Y)"},{"key":"key-10.3201\/eid2905.221421-202304241738-R50","unstructured":"United States Interagency Council on Homelessness. West Virginia homelessness statistics. 2020 [cited 2022 May 5]. https:\/\/www.usich.gov\/homelessness-statistics\/wv"}],"container-title":["Emerging Infectious Diseases"],"original-title":[],"link":[{"URL":"https:\/\/wwwnc.cdc.gov\/eid\/article\/29\/5\/22-1421_article","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,30]],"date-time":"2024-11-30T17:59:06Z","timestamp":1732989546000},"score":1,"resource":{"primary":{"URL":"https:\/\/wwwnc.cdc.gov\/eid\/article\/29\/5\/22-1421_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":50,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5]]}},"URL":"https:\/\/doi.org\/10.3201\/eid2905.221421","relation":{},"ISSN":["1080-6040","1080-6059"],"issn-type":[{"value":"1080-6040","type":"print"},{"value":"1080-6059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}