Hall, Jennifer N; Armitage, Edwin P; Senghore, Elina; Darboe, Saffiatou; Barry, Momodou; Camara, Janko; Bah, Sulayman; Keeley, Alexander J; McCarthy, James S; Smeesters, Pierre; +5 more... Turner, Claire E; Darton, Thomas C; Marks, Michael; Angyal, Adrienn; de Silva, Thushan I; (2024) Molecular methods enhance the detection of pyoderma-related Streptococcus pyogenes and emm-type distribution in children. The Journal of infectious diseases. jiae359-. ISSN 0022-1899 DOI: https://doi.org/10.1093/infdis/jiae359
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Abstract
BACKGROUND: Streptococcus pyogenes-related skin infections are increasingly implicated in the development of rheumatic heart disease (RHD) in lower-resourced settings, where they are often associated with scabies. The true prevalence of S. pyogenes-related pyoderma may be underestimated by bacterial culture. METHODS: A multiplex qPCR for S. pyogenes, Staphylococcus aureus and Sarcoptes scabiei was applied to 250 pyoderma swabs from a cross-sectional study of children <5 years in The Gambia. Direct PCR-based emm-typing was used to supplement previous whole genome sequencing (WGS) of cultured isolates. RESULTS: Pyoderma lesions with S. pyogenes increased from 51% (127/250) using culture to 80% (199/250) with qPCR. Compared to qPCR, the sensitivity of culture was 95.4% for S. pyogenes (95% CI 77.2-99.9) in samples with S. pyogenes alone (22/250, 9%), but 59.9% (95% CI 52.3-67.2) for samples with S. aureus co-infection (177/250, 71%). Direct PCR-based emm-typing was successful in 50% (46/92) of cases, identifying 27 emm-types, including six not identified by WGS (total 52 emm-types). CONCLUSIONS: Bacterial culture significantly underestimates the burden of S. pyogenes in pyoderma, particularly when co-infected with S. aureus. Molecular methods should be used to enhance the detection of S. pyogenes in surveillance studies and clinical trials of preventative measures in RHD-endemic settings.
Item Type | Article |
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Faculty and Department |
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research Faculty of Infectious and Tropical Diseases > Dept of Disease Control |
PubMed ID | 39008379 |
Elements ID | 226891 |
Official URL | http://dx.doi.org/10.1093/infdis/jiae359 |
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Filename: Hall-etal-2024-Molecular-Methods-Enhance-the-Detection-of-Pyoderma-Related-Streptococcus-pyogenes-and-emm-Type-Distribution-in-Children.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
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