Evidence map›Paper›PMID 32289480›Full record

ArticleClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2021

Genetic evolution of invasive emm28 Streptococcus pyogenes strains and significant association with puerperal infections in young women in Finland.

K Gröndahl-Yli-Hannuksela, S B Beres, H-L Hyyryläinen, T Kallonen, J M Musser, J Vuopio

Open access · bronzeAbstract read
In one paragraph

Article in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 15 citations in OpenAlex.

  1. Streptococcus pyogenes endometritis- a population-based study on the causative emm-types, case clustering and disease severity.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    Article
  2. Molecular and Clinical Characterization of InvasivePathogens (Basel, Switzerland) · 2025
    Article
  3. The group AInfection and immunity · 2025
    Article
  4. Review
  5. Group A Streptococcus vulvovaginitis in Spain, 2011-2023: antibiotic resistance and emm-type distribution.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
    Article
  6. A model for predicting bacteremia species based on host immune response.Frontiers in cellular and infection microbiology · 2025
    Article
  7. Epidemiology and emm types among group A streptococcal pharyngitis in Finland: a prospective laboratory-based study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024
    Article
  8. Article
  9. Article
  10. Review
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

K Gröndahl-Yli-HannukselaInstitute of Biomedicine, University of Turku, Turku, Finland. Electronic address: kagron@utu.fi.
S B BeresCenter for Molecular and Translational Human Infectious Diseases Research, Department of Pathology and Genomic Medicine, Houston Methodist Research Institute and Houston Methodist Hospital, Houston, TX, USA.
H-L HyyryläinenDepartment of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland.
T KallonenDepartment of Biostatistics, University of Oslo, Oslo, Norway.
J M MusserCenter for Molecular and Translational Human Infectious Diseases Research, Department of Pathology and Genomic Medicine, Houston Methodist Research Institute and Houston Methodist Hospital, Houston, TX, USA.
J VuopioInstitute of Biomedicine, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland.
Houston Methodist · USUniversity of Turku · FIFinnish Institute for Health and Welfare · FIUniversity of Oslo · NO

Funding

Determinants of Streptococcus pyogenes virulence in the primate oropharynx: A genome-wide analysisR21AI139369 · NIAID · METHODIST HOSPITAL RESEARCH INSTITUTE · PI MUSSER, JAMES MALLORY · 2019 to 2020
$444k
Determinants of Streptococcus pyogenes fitness in the female primate genital tract: A genome-wide analysisR21AI146771 · NIAID · METHODIST HOSPITAL RESEARCH INSTITUTE · PI MUSSER, JAMES MALLORY · 2019 to 2020
$444k
NIAID NIH HHS R21 AI139369NIAID NIH HHS R21 AI146771
6 · The paper itself

Abstract

objectivesStreptococcus pyogenes or group A streptococcus (GAS) is a human specific pathogen that annually infects over 700 million individuals. GAS strains of type emm28 are an abundant cause of invasive infections in Europe and North America.

methodsWe conducted a population-based study on bacteraemic emm28 GAS cases in Finland, from 1995 to 2015. Whole-genome sequencing (WGS) was used to genetically characterize the bacterial isolates. Bayesian analysis of the population structure was used to define genetic clades. Register-linkage analysis was performed to test for association of emm28 GAS with delivery- or postpartum-related infections. A genome-wide association study was used to search for DNA sequences associated with delivery or puerperal infections.

resultsAmong 3060 bacteraemic cases reported during the study period, 714 were caused by emm28. Women comprised a majority of cases (59 %, 422/714), and were significantly over-represented (84.4 %, 162/192, p < 0.0001) among cases in the childbearing age group (20-40 years). Register-linkage analysis revealed strong association (p < 0.0001) of emm28 bacteraemias with delivery and puerperium. In this register-linkage analysis, 120 women with GAS bacteraemia were identified and linked to delivery, infections during delivery or puerperium time. Among these the proportion of cases caused by emm28 was significantly higher than any other emm type (55.8%, 67/120, p < 0.0001). Among the four genetic subclades identified, SC1B has dominated among the bacteraemic cases since 2000. Altogether 620 of 653 (94.9%) isolates belonged to SC1B. No specific sequence or genetic clade was found nonrandomly associated with delivery or puerperal infections.

conclusionsWomen of childbearing age were significantly overrepresented among bacteraemic emm28 GAS cases, and in particular were strongly associated with delivery and puerperium cases over the 21 years studied. The molecular mechanisms behind these associations are unclear and warrant further investigation.

Indexed as

AdolescentAdultAgedAged, 80 and overAntigens, BacterialBacteremiaChildChild, PreschoolFemaleFinlandHumansInfantInfant, NewbornMiddle AgedPregnancyPuerperal InfectionAntigens, BacterialBacteraemicGroup A streptococcusPuerperal sepsisStreptococcus pyogenesWhole-genome sequencing

Identifiers

PMID32289480
PMCPMC7780161
OpenAlexW3015510159

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.