ArticleProceedings of the National Academy of Sciences of the United States of America2014
Evolutionary pathway to increased virulence and epidemic group A Streptococcus disease derived from 3,615 genome sequences.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 169 papers.
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169 citing papers in PubMed, 266 citations in OpenAlex.
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- Evaluating the use of whole-genome sequencing and SangerJournal of medical microbiology · 2026Article
- Evidence for early circulation of the M1UK sublineage of Streptococcus pyogenes in Germany, 2015-2023.Emerging microbes & infections · 2025Article
- Invasive Group A Streptococcus infections in children during the post-pandemic period: results from a multicenter study in Italy.Italian journal of pediatrics · 2025Observational
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- Group A Streptococcus among American Indian Persons, White Mountain Apache Tribal Lands, United States, 2016-2019Emerging infectious diseases · 2025Article
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- Comparison of pharyngeal and invasive isolates ofMicrobiology spectrum · 2025Article
- Invasive Group A Streptococcal Infection in Children, 1992-2023.JAMA network open · 2025Article
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- A Rapid Molecular Detection Tool for Toxigenic M1UK Streptococcus pyogenes.The Journal of infectious diseases · 2025Article
- Novel assembly of the SF370 strain of the important human pathogenMicrobiology resource announcements · 2025Article
- Global spread of Streptococcus pyogenes A genomics-supported narrative review.FEMS microbiology reviews · 2025Review
- The intricate pathogenicity of Group AVirulence · 2024Review
- Clinical Snapshot of Group A Streptococcal Isolates from an Australian Tertiary Hospital.Pathogens (Basel, Switzerland) · 2024Article
- Nationwide upsurge in invasive disease in the context of longitudinal surveillance of carriage and invasiveJournal of clinical microbiology · 2024Article
- Epidemiology of Streptococcus pyogenes upper respiratory tract infections in Poland (2003-2017).Journal of applied genetics · 2024Article
109 more citing papers are in PubMed but not listed here.
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19 authors at 11 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We sequenced the genomes of 3,615 strains of serotype Emm protein 1 (M1) group A Streptococcus to unravel the nature and timing of molecular events contributing to the emergence, dissemination, and genetic diversification of an unusually virulent clone that now causes epidemic human infections worldwide. We discovered that the contemporary epidemic clone emerged in stepwise fashion from a precursor cell that first contained the phage encoding an extracellular DNase virulence factor (streptococcal DNase D2, SdaD2) and subsequently acquired the phage encoding the SpeA1 variant of the streptococcal pyrogenic exotoxin A superantigen. The SpeA2 toxin variant evolved from SpeA1 by a single-nucleotide change in the M1 progenitor strain before acquisition by horizontal gene transfer of a large chromosomal region encoding secreted toxins NAD(+)-glycohydrolase and streptolysin O. Acquisition of this 36-kb region in the early 1980s into just one cell containing the phage-encoded sdaD2 and speA2 genes was the final major molecular event preceding the emergence and rapid intercontinental spread of the contemporary epidemic clone. Thus, we resolve a decades-old controversy about the type and sequence of genomic alterations that produced this explosive epidemic. Analysis of comprehensive, population-based contemporary invasive strains from seven countries identified strong patterns of temporal population structure. Compared with a preepidemic reference strain, the contemporary clone is significantly more virulent in nonhuman primate models of pharyngitis and necrotizing fasciitis. A key finding is that the molecular evolutionary events transpiring in just one bacterial cell ultimately have produced millions of human infections worldwide.
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