Rapid expansion and international spread of M1UK in the post-pandemic UK upsurge of Streptococcus pyogenes

Ana Vieira, Yu Wan, Yan Ryan, Ho Kwong Li, Rebecca L. Guy, Maria Papangeli, Kristin K. Huse, Lucy C. Reeves, Valerie W. C. Soo, Roger Daniel, Alessandra Harley, Karen Broughton, Chenchal Dhami, Mark Ganner, Marjorie A. Ganner, Zaynab Mumin, Maryam Razaei, Emma Rundberg, Rufat Mammadov, Ewurabena A. Mills, Vincenzo Sgro, Kai Yi Mok, Xavier Didelot, Nicholas J. Croucher, Elita Jauneikaite, Theresa Lamagni, Colin S. Brown, Juliana Coelho () and Shiranee Sriskandan ()
Additional contact information
Ana Vieira: Imperial College London
Yu Wan: Imperial College London
Yan Ryan: UK Health Security Agency
Ho Kwong Li: Imperial College London
Rebecca L. Guy: UK Health Security Agency
Maria Papangeli: Imperial College London
Kristin K. Huse: Imperial College London
Lucy C. Reeves: Imperial College London
Valerie W. C. Soo: Imperial College London
Roger Daniel: UK Health Security Agency
Alessandra Harley: UK Health Security Agency
Karen Broughton: UK Health Security Agency
Chenchal Dhami: UK Health Security Agency
Mark Ganner: UK Health Security Agency
Marjorie A. Ganner: UK Health Security Agency
Zaynab Mumin: UK Health Security Agency
Maryam Razaei: UK Health Security Agency
Emma Rundberg: UK Health Security Agency
Rufat Mammadov: UK Health Security Agency
Ewurabena A. Mills: Imperial College London
Vincenzo Sgro: Imperial College London
Kai Yi Mok: Imperial College London
Xavier Didelot: University of Warwick
Nicholas J. Croucher: Imperial College London
Elita Jauneikaite: Imperial College London
Theresa Lamagni: Imperial College London
Colin S. Brown: Imperial College London
Juliana Coelho: Imperial College London
Shiranee Sriskandan: Imperial College London

Nature Communications, 2024, vol. 15, issue 1, 1-11

Abstract: Abstract The UK observed a marked increase in scarlet fever and invasive group A streptococcal infection in 2022 with severe outcomes in children and similar trends worldwide. Here we report lineage M1UK to be the dominant source of invasive infections in this upsurge. Compared with ancestral M1global strains, invasive M1UK strains exhibit reduced genomic diversity and fewer mutations in two-component regulator genes covRS. The emergence of M1UK is dated to 2008. Following a bottleneck coinciding with the COVID-19 pandemic, three emergent M1UK clades underwent rapid nationwide expansion, despite lack of detection in previous years. All M1UK isolates thus-far sequenced globally have a phylogenetic origin in the UK, with dispersal of the new clades in Europe. While waning immunity may promote streptococcal epidemics, the genetic features of M1UK point to a fitness advantage in pathogenicity, and a striking ability to persist through population bottlenecks.

Date: 2024
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DOI: 10.1038/s41467-024-47929-7

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