Skip to content

Research at St Andrews

2015 epidemic of severe Streptococcus agalactiae sequence type 283 infections in Singapore associated with the consumption of raw freshwater fish: a detailed analysis of clinical, epidemiological, and bacterial sequencing data

Research output: Contribution to journalArticle

DOI

Open Access permissions

Open

Author(s)

Shirin Kalimuddin, Swaine L Chen, Cindy T K Lim, Tse Hsien Koh, Thean Yen Tan, Michelle Kam, Christopher W Wong, Kurosh S Mehershahi, Man Ling Chau, Lee Ching Ng, Wen Ying Tang, Hishamuddin Badaruddin, Jeanette Teo, Anucha Apisarnthanarak, Nuntra Suwantarat, Margaret Ip, Matthew T G Holden, Li Yang Hsu, Timothy Barkham, for the Singapore Group B Streptococcus Consortium

School/Research organisations

Abstract

Background: Streptococcus agalactiae (group B Streptococcus [GBS]) has not been described as a foodborne pathogen. However, in 2015, a large outbreak of severe invasive sequence type (ST) 283 GBS infections in adults epidemiologically linked to the consumption of raw freshwater fish occurred in Singapore. We attempted to determine the scale of the outbreak, define the clinical spectrum of disease, and link the outbreak to contaminated fish.

Methods: Time-series analysis was performed on microbiology laboratory data. Food handlers and fishmongers were screened for enteric carriage of GBS. A retrospective cohort study was conducted to assess differences in demographic and clinical characteristics of patients with invasive ST283 and non-ST283 infections. Whole-genome sequencing was performed on human and fish ST283 isolates from Singapore, Thailand, and Hong Kong.

Results: The outbreak was estimated to have started in late January 2015. Within the study cohort of 408 patients, ST283 accounted for 35.8% of cases. Patients with ST283 infection were younger and had fewer comorbidities but were more likely to develop meningoencephalitis, septic arthritis, and spinal infection. Of 82 food handlers and fishmongers screened, none carried ST283. Culture of 43 fish samples yielded 13 ST283-positive samples. Phylogenomic analysis of 161 ST283 isolates from humans and fish revealed they formed a tight clade distinguished by 93 single-nucleotide polymorphisms.

Conclusions: ST283 is a zoonotic GBS clone associated with farmed freshwater fish, capable of causing severe disease in humans. It caused a large foodborne outbreak in Singapore and poses both a regional and potentially more widespread threat.

Close

Details

Original languageEnglish
Pages (from-to)S145-S152
Number of pages8
JournalClinical Infectious Diseases
Volume64
Issue numbersuppl_2
Early online date29 Apr 2017
DOIs
StatePublished - 15 May 2017

    Research areas

  • Outbreak, Streptococcus agalactiae, Group B Streptococcus, Foodborne, Zoonosis

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Global scale dissemination of ST93: a divergent Staphylococcus aureus epidemic lineage that has recently emerged from remote Northern Australia

    van Hal, S. J., Steinig, E. J., Andersson, P., Holden, M. T. G., Harris, S. R., Nimmo, G. R., Williamson, D. A., Heffernan, H., Ritchie, S. R., Kearns, A. M., Ellington, M. J., Dickson, E., de Lencastre, H., Coombs, G. W., Bentley, S. D., Parkhill, J., Holt, D. C., Giffard, P. M. & Tong, S. Y. C. 9 Jul 2018 In : Frontiers in Microbiology. 9, 11 p., 1453

    Research output: Contribution to journalArticle

  2. Comparative sequence analysis of the capsular polysaccharide loci of Actinobacillus pleuropneumoniae serovars 1-18, and development of two multiplex PCRs for comprehensive capsule typing

    Bossé, J. T., Li, Y., Fernandez Crespo, R., Lacouture, S., Gottschalk, M., Sárközi, R., Fodor, L., Casas Amoribieta, M., Angen, Ø., Nedbalcova, K., Holden, M. T. G., Maskell, D. J., Tucker, A. W., Wren, B. W., Rycroft, A. N., Langford, P. R. & on behalf of the BRaDP1T consortium Jul 2018 In : Veterinary Microbiology. 220, p. 83-89 7 p.

    Research output: Contribution to journalArticle

  3. An outbreak of Streptococcus pyogenes in a mental health facility: advantage of well-timed whole-genome sequencing over emm typing

    Bergin, S. M. , Periaswamy, B. , Barkham, T. , Chua, H. C. , Mok, Y. M. , Fung, D. S. S. , Su, A. H. C. , Lee, Y. L. , Chua, M. L. I. , Ng, P. Y. , Soon, W. J. W. , Chu, C. W. , Tan, S. L. , Meehan, M. , Ang, B. S. P. , Leo, Y. S. , Holden, M. T. G. , De, P. , Hsu, L. Y. , Chen, S. L. & 2 others de Sessions, P. F. & Marimuthu, K. 9 May 2018 In : Infection Control and Hospital Epidemiology. First View, 9 p.

    Research output: Contribution to journalArticle

  4. The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from Atopic Dermatitis patients

    Harkins, C. P., McAleer, M. A., Bennett, D., McHugh, M., Fleury, O. M., Pettigrew, K. A., Oravcová, K., Parkhill, J., Proby, C. M., Dawe, R. S., Geoghegan, J. A., Irvine, A. D. & Holden, M. T. G. 5 May 2018 (Accepted/In press) In : British Journal of Dermatology. In press

    Research output: Contribution to journalArticle

  5. Distinct evolutionary patterns of Neisseria meningitidis serogroup B disease outbreaks at two universities in the USA

    Hao, L., Holden, M. T. G., Wang, X., Andrew, L., Wellnitz, S., Hu, F., Whaley, M., Sammons, S., Knipe, K., Frace, M., McNamara, L. A., Liberator, P. & Anderson, A. S. Apr 2018 In : Microbial Genomics. 4, 4, 10 p., e000155

    Research output: Contribution to journalArticle

Related by journal

  1. Late presentation with HIV in Africa: phenotypes, risk, and risk stratification in the REALITY trial

    Siika, A. , McCabe, L. , Bwakura-Dangarembizi, M. , Kityo, C. , Mallewa, J. , Berkley, J. , Maitland, K. , Griffiths, A. , Baleeta, K. , Mudzingwa, S. , Abach, J. , Nathoo, K. , Thomason, M. J. , Prendergast, A. J. , Walker, A. S. , Gibb, D. M. , Mugyenyi, P. , Kityo, C. , Musiime, V. , Wavamunno, P. & 31 others Nambi, E., Ocitti, P., Ndigendawani, M., Kemigisa, M., Acen, J., Olebo, D., Mpamize, G., Amone, A., Okweny, D., Mbonye, A., Nambaziira, F., Rweyora, A., Kangah, M., Kabaswahili, V., Abach, J., Abongomera, G., Omongin, J., Aciro, I., Philliam, A., Arach, B., Ocung, E., Amone, G., Miles, P., Adong, C., Tumsuiime, C., Kidega, P., Otto, B., Apio, F., Baleeta, K., O'Hare, B. & REALITY Trial Team 1 Apr 2018 In : Clinical Infectious Diseases. 66, p. S140-S146

    Research output: Contribution to journalArticle

  2. The potential for treatment shortening with higher rifampicin doses: relating drug exposure to treatment response in patients with pulmonary tuberculosis

    Svensson, E. M., Svensson, R. J., Te Brake, L. H. M., Boeree, M. J., Heinrich, N., Konsten, S., Churchyard, G., Dawson, R., Diacon, A. H., Kibiki, G. S., Minja, L. T., Ntingiya, N. E., Sanne, I., Gillespie, S. H., Hoelscher, M., Phillips, P. P. J., Simonsson, U. S. H. & Aarnoutse, R. 18 Jun 2018 In : Clinical Infectious Diseases. 67, 1, p. 34-41 8 p.

    Research output: Contribution to journalArticle

  3. MRSA transmission dynamics among interconnected acute, intermediate-term, and long-term healthcare facilities in Singapore

    Chow, A., Lim, V. W., Khan, A., Pettigrew, K., Lye, D. C. B., Kanagasabai, K., Phua, K., Krishnan, P., Ang, B., Marimuthu, K., Hon, P-Y., Koh, J., Leong, I., Parkhill, J., Hsu, L-Y. & Holden, M. T. G. 15 May 2017 In : Clinical Infectious Diseases. 64, suppl_2, p. S76-S81 6 p.

    Research output: Contribution to journalArticle

  4. Factors underlying Ebola virus infection among health workers, Kenema, Sierra Leone, 2014-2015

    Senga, M., Pringle, K., Ramsay, A., Brett-Major, D. M., Fowler, R. A., French, I., Vandi, M., Sellu, J., Pratt, C., Saidu, J., Shindo, N., Bausch, D. G. & for the Sierra Leone Kenema District Task Force and Kenema General Hospital 15 Aug 2016 In : Clinical Infectious Diseases. 63, 4, p. 454-459 6 p.

    Research output: Contribution to journalArticle

ID: 249970513