Molecular characterization of the 2011 Hong Kong scarlet fever outbreak

Tse, Herman, Bao, Jessie Y. J., Davies, Mark R., Maamary, Peter, Tsoi, Hoi-Wah, Tong, Amy H. Y., Ho, Tom C. C., Lin, Chi-Ho, Gillen, Christine M., Barnett, Timothy C., Chen, Jonathan H. K., Lee, Mianne, Yam, Wing-Cheong, Wong, Chi-Kin, Ong, Cheryl-lynn Y., Chan, Yee-Wai, Wu, Cheng-Wei, Ng, Tony, Lim, Wilina W. L., Tsang, Thomas H. F., Tse, Cindy W. S., Dougan, Gordon, Walker, Mark J., Lok, Si and Yuen, Kwok-Yung (2012) Molecular characterization of the 2011 Hong Kong scarlet fever outbreak. The Journal of Infectious Diseases, 206 3: 341-351. doi:10.1093/infdis/jis362

Author Tse, Herman
Bao, Jessie Y. J.
Davies, Mark R.
Maamary, Peter
Tsoi, Hoi-Wah
Tong, Amy H. Y.
Ho, Tom C. C.
Lin, Chi-Ho
Gillen, Christine M.
Barnett, Timothy C.
Chen, Jonathan H. K.
Lee, Mianne
Yam, Wing-Cheong
Wong, Chi-Kin
Ong, Cheryl-lynn Y.
Chan, Yee-Wai
Wu, Cheng-Wei
Ng, Tony
Lim, Wilina W. L.
Tsang, Thomas H. F.
Tse, Cindy W. S.
Dougan, Gordon
Walker, Mark J.
Lok, Si
Yuen, Kwok-Yung
Title Molecular characterization of the 2011 Hong Kong scarlet fever outbreak
Journal name The Journal of Infectious Diseases   Check publisher's open access policy
ISSN 0022-1899
Publication date 2012-08
Sub-type Article (original research)
DOI 10.1093/infdis/jis362
Volume 206
Issue 3
Start page 341
End page 351
Total pages 11
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2013
Language eng
Formatted abstract
A scarlet fever outbreak occurred in Hong Kong in 2011. The majority of cases resulted in the isolation of Streptococcus pyogenes emm12 with multiple antibiotic resistances. Phylogenetic analysis of 22 emm12 scarlet fever outbreak isolates, 7 temporally and geographically matched emm12 non–scarlet fever isolates, and 18 emm12 strains isolated during 2005–2010 indicated the outbreak was multiclonal. Genome sequencing of 2 nonclonal scarlet fever isolates (HKU16 and HKU30), coupled with diagnostic polymerase chain reaction assays, identified 2 mobile genetic elements distributed across the major lineages: a 64.9-kb integrative and conjugative element encoding tetracycline and macrolide resistance and a 46.4-kb prophage encoding superantigens SSA and SpeC and the DNase Spd1. Phenotypic comparison of HKU16 and HKU30 with the S. pyogenes M1T1 strain 5448 revealed that HKU16 displays increased adherence to HEp-2 human epithelial cells, whereas HKU16, HKU30, and 5448 exhibit equivalent resistance to neutrophils and virulence in a humanized plasminogen murine model. However, in contrast to M1T1, the virulence of HKU16 and HKU30 was not associated with covRS mutation. The multiclonal nature of the emm12 scarlet fever isolates suggests that factors such as mobile genetic elements, environmental factors, and host immune status may have contributed to the 2011 scarlet fever outbreak.
Keyword Group-A streptococcus
Genome sequence
Invasive disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Chemistry and Molecular Biosciences
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