澳大利亚维多利亚州侵袭性A组链球菌（iGAS）流行病学及COVID-19影响的基因组研究：一项6年回顾性研究。
Genomic interrogation of invasive group A (iGAS) epidemiology and COVID-19 impacts in Victoria, Australia: a 6-year retrospective study.
作者信息
Morris Jacqueline M, Lacey Jake A, Stevens Kerrie, Kumar Lamali Sadeesh, Wilmot Mathilda, Strachan Janet, Easton Marion, Hennessy Daneeta, Korman Tony M, Daley Andrew J, Gibney Katherine B, Jenney Adam W J, Tong Steven Y C, Howden Benjamin P, Sherry Norelle L
机构信息
Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
出版信息
Lancet Reg Health West Pac. 2025 Jan 29;55:101467. doi: 10.1016/j.lanwpc.2025.101467. eCollection 2025 Feb.
BACKGROUND
Invasive group A (iGAS) cases have increased globally in 2022-2023, raising concerns within the medical and public health communities, including in Australia, while this impact is polyclonal in nature the worldwide spread and dominance of M1 has been particularly concerning.
METHODS
To investigate these changes and prepare to implement routine genomic surveillance of iGAS for public health purposes, we performed whole genome sequencing (WGS) on iGAS isolates from Victoria, Australia between 2017 and 2022. Genomic analyses were conducted to determine the epidemiology, genetic diversity, and population dynamics of iGAS.
FINDINGS
Analysis of 955 confirmed iGAS cases over a 6-year period revealed a polyclonal population. Fewer iGAS cases were noted between 2020 and 2021 in addition to genetic bottlenecks, likely reflecting the implementation of strict public health measures during the COVID pandemic, followed by a resurgence in cases post-COVID. Low levels of antimicrobial resistance were observed, primarily to macrolides and tetracyclines. Phylogenetic analysis identified a previously undescribed sub-lineage, designated M1 detected in Australia (Victoria and Queensland), Belgium and the United Kingdom. In Victoria, M1 was the dominant variant in 2017 and 2018, more recently replaced by the M1 lineage as the dominant variant, further demonstrating the worldwide impact of M1.
INTERPRETATION
This comprehensive genomic study of iGAS in Victoria, Australia provides valuable insights into the population dynamics, genetic diversity, and impact of pandemic public health measures on iGAS epidemiology. The identification of the M1 sub-lineage emphasises the need for continued genomic surveillance and monitoring of iGAS strains, particularly in the context of emerging global sub-lineages and shifts in population structure.
FUNDING
MDU PHL-Department of Health, Victoria. NHMRC (GNT1196103 to BPH; Partnership Grant GNT1149991).
背景
2022 - 2023年全球侵袭性A群链球菌（iGAS）病例有所增加，这引发了医学和公共卫生界的担忧，澳大利亚也不例外。虽然这种影响本质上是多克隆的，但M1在全球的传播和主导地位尤其令人担忧。
方法
为了调查这些变化并准备实施用于公共卫生目的的iGAS常规基因组监测，我们对2017年至2022年期间从澳大利亚维多利亚州分离出的iGAS菌株进行了全基因组测序（WGS）。进行基因组分析以确定iGAS的流行病学、遗传多样性和种群动态。
研究结果
对6年期间955例确诊的iGAS病例进行分析，发现其种群是多克隆的。2020年至2021年期间iGAS病例减少，同时出现了遗传瓶颈，这可能反映了新冠疫情期间严格公共卫生措施的实施，随后疫情后病例又有所回升。观察到的抗菌药物耐药水平较低，主要针对大环内酯类和四环素类。系统发育分析确定了一个先前未描述的亚谱系，命名为M1，在澳大利亚（维多利亚州和昆士兰州）、比利时和英国均有检测到。在维多利亚州，M1在2017年和2018年是主要变体，最近被M1谱系取代成为主要变体，进一步证明了M1在全球的影响。
解读
这项对澳大利亚维多利亚州iGAS的全面基因组研究，为iGAS的种群动态、遗传多样性以及大流行公共卫生措施对iGAS流行病学的影响提供了有价值的见解。M1亚谱系的识别强调了持续进行iGAS菌株基因组监测和监测的必要性，特别是在全球新兴亚谱系和种群结构变化的背景下。
资金来源
维多利亚州卫生部MDU PHL。澳大利亚国家卫生与医学研究委员会（授予BPH的GNT1196103；合作资助GNT1149991）。
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