ArticleJournal of clinical microbiology2016
High Incidence of Invasive Group A Streptococcus Disease Caused by Strains of Uncommon emm Types in Thunder Bay, Ontario, Canada.
Article in Journal of clinical microbiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 3 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Dermatologic conditions and risk factors in people experiencing homelessness (PEH): systematic review.Archives of dermatological research · 2023Pooled it
- Invasive group A streptococcal disease in pregnant women and young children: a systematic review and meta-analysis.The Lancet. Infectious diseases · 2022Pooled it
- Infectious Diseases Among People Experiencing Homelessness: A Systematic Review of the Literature in the United States and Canada, 2003-2022.Public health reports (Washington, D.C. : 1974)Pooled it
- Group A Streptococcus among American Indian Persons, White Mountain Apache Tribal Lands, United States, 2016-2019Emerging infectious diseases · 2025Article
- Insights gained from sequencing Australian non-invasive and invasiveMicrobial genomics · 2024Article
- Invasive group A streptococcal (iGAS) surveillance in Island Health, British Columbia, 2022.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2023Article
- A review of penicillin binding protein and group AFrontiers in cellular and infection microbiology · 2023Review
- Invasive Group A Streptococcal Infections Among People Who Inject Drugs and People Experiencing Homelessness in the United States, 2010-2017.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Invasive bacterial diseases in northern Canada, 1999 to 2018.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2021Article
- The development of a community-based public health response to an outbreak of post-streptococcal glomerulonephritis in a First Nations community.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2021Article
- Application of the random forest algorithm to Streptococcus pyogenes response regulator allele variation: from machine learning to evolutionary models.Scientific reports · 2021Article
- A Review ofPathogens (Basel, Switzerland) · 2021Review
- Cryptic prophages within aMicrobial genomics · 2021Article
- Disparate Effects of Invasive Group A Streptococcus on Native Americans.Emerging infectious diseases · 2020Article
- Article
- Communicable disease among people experiencing homelessness in California.Epidemiology and infection · 2020Article
- Risk factors associated with group A Streptococcus acquisition in a large, urban homeless shelter outbreak.Canadian journal of public health = Revue canadienne de sante publique · 2020Article
- Gut Microbiota Plasticity Influences the Adaptability of Wild and Domestic Animals in Co-inhabited Areas.Frontiers in microbiology · 2020Article
- Article
- Evaluation of Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry and ClinPro Tools as a Rapid Tool for TypingOpen forum infectious diseases · 2019Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
An outbreak of type emm59 invasive group A Streptococcus (iGAS) disease was declared in 2008 in Thunder Bay District, Northwestern Ontario, 2 years after a countrywide emm59 epidemic was recognized in Canada. Despite a declining number of emm59 infections since 2010, numerous cases of iGAS disease continue to be reported in the area. We collected clinical information on all iGAS cases recorded in Thunder Bay District from 2008 to 2013. We also emm typed and sequenced the genomes of all available strains isolated from 2011 to 2013 from iGAS infections and from severe cases of soft tissue infections. We used whole-genome sequencing data to investigate the population structure of GAS strains of the most frequently isolated emm types. We report an increased incidence of iGAS in Thunder Bay compared to the metropolitan area of Toronto/Peel and the province of Ontario. Illicit drug use, alcohol abuse, homelessness, and hepatitis C infection were underlying diseases or conditions that might have predisposed patients to iGAS disease. Most cases were caused by clonal strains of skin or generalist emm types (i.e., emm82, emm87, emm101, emm4, emm83, and emm114) uncommonly seen in other areas of the province. We observed rapid waxing and waning of emm types causing disease and their replacement by other emm types associated with the same tissue tropisms. Thus, iGAS disease in Thunder Bay District predominantly affects a select population of disadvantaged persons and is caused by clonally related strains of a few skin and generalist emm types less commonly associated with iGAS in other areas of Ontario.
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