ArticleJournal of clinical microbiology2013
Molecular analysis of an outbreak of lethal postpartum sepsis caused by Streptococcus pyogenes.
Article in Journal of clinical microbiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Integration of Genomic and Other Epidemiologic Data to Investigate and Control a Cross-Institutional Outbreak of Streptococcus pyogenes.Emerging infectious diseases · 2016Pooled it
- Immunity to Streptococcus pyogenes and Common Respiratory Viruses at Age 0 to 4 Years After COVID-19 Restrictions.JAMA network open · 2025Article
- Lingual necrosis secondary to group a streptococcal necrotising infection.Oxford medical case reports · 2025Article
- Generation of tools for expression and purification of the phage-encoded Type I restriction enzyme inhibitor, Ocr.Microbiology (Reading, England) · 2024Article
- Insights gained from sequencing Australian non-invasive and invasiveMicrobial genomics · 2024Article
- Methylome-dependent transformation ofmBio · 2023Article
- Commensal bacteria augment Staphylococcus aureus infection by inactivation of phagocyte-derived reactive oxygen species.PLoS pathogens · 2021Article
- Vaccine-induced, but not natural immunity, against the Streptococcal inhibitor of complement protects against invasive disease.NPJ vaccines · 2021Article
- Emergence of dominant toxigenic M1T1 Streptococcus pyogenes clone during increased scarlet fever activity in England: a population-based molecular epidemiological study.The Lancet. Infectious diseases · 2019Article
- A Mobile Genetic Element Promotes the Association Between Serotype M28 Group A Streptococcus Isolates and Cases of Puerperal Sepsis.The Journal of infectious diseases · 2019Article
- Prolonged and large outbreak of invasive group A Streptococcus disease within a nursing home: repeated intrafacility transmission of a single strain.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2019Article
- Proteomic analysis at the sites of clinical infection with invasive Streptococcus pyogenes.Scientific reports · 2018Article
- Impact of contusion injury on intramuscular emm1 group a streptococcus infection and lymphatic spread.Virulence · 2018Article
- Community outbreaks of group A Streptococcus revealed by genome sequencing.Scientific reports · 2017Observational
- Multi-functional mechanisms of immune evasion by the streptococcal complement inhibitor C5a peptidase.PLoS pathogens · 2017Article
- Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 2013.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2017Article
- Article
- Scarlet Fever Upsurge in England and Molecular-Genetic Analysis in North-West London, 2014.Emerging infectious diseases · 2016Article
- Interleukin-17A Contributes to the Control of Streptococcus pyogenes Colonization and Inflammation of the Female Genital Tract.Scientific reports · 2016Article
- Characteristics of mucoidIDCases · 2016Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
Sepsis is now the leading direct cause of maternal death in the United Kingdom, and Streptococcus pyogenes is the leading pathogen. We combined conventional and genomic analyses to define the duration and scale of a lethal outbreak. Two postpartum deaths caused by S. pyogenes occurred within 24 h; one was characterized by bacteremia and shock and the other by hemorrhagic pneumonia. The women gave birth within minutes of each other in the same maternity unit 2 days earlier. Seven additional infections in health care and household contacts were subsequently detected and treated. All cluster-associated S. pyogenes isolates were genotype emm1 and were initially indistinguishable from other United Kingdom emm1 isolates. Sequencing of the virulence gene sic revealed that all outbreak isolates had the same unique sic type. Genome sequencing confirmed that the cluster was caused by a unique S. pyogenes clone. Transmission between patients occurred on a single day and was associated with casual contact only. A single isolate from one patient demonstrated a sequence change in sic consistent with longer infection duration. Transmission to health care workers was traced to single clinical contacts with index cases. The last case was detected 18 days after the first case. Following enhanced surveillance, the outbreak isolate was not detected again. Mutations in bacterial regulatory genes played no detectable role in this outbreak, illustrating the intrinsic ability of emm1 S. pyogenes to spread while retaining virulence. This fast-moving outbreak highlights the potential of S. pyogenes to cause a range of diseases in the puerperium with rapid transmission, underlining the importance of immediate recognition and response by clinical infection and occupational health teams.
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