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, 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
Publication statusPublished - 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. Improved characterisation of MRSA transmission using within-host bacterial sequence diversity

    Hall, M. D., Holden, M. TG., Srisomang, P., Mahavanakul, W., Wuthiekanun, V., Limmathurotsakul, D., Fountain, K., Parkhill, J., Nickerson, E. K., Peacock, S. J. & Fraser, C., 8 Oct 2019, In : eLife. 8

    Research output: Contribution to journalArticle

  2. Genomic identification of cryptic susceptibility to penicillins and β-lactamase inhibitors in methicillin-resistant Staphylococcus aureus

    Harrison, E. M., Ba, X., Coll, F., Blane, B., Restif, O., Carvell, H., Köser, C. U., Jamrozy, D., Reuter, S., Lovering, A., Gleadall, N., Bellis, K. L., Uhlemann, A. C., Lowy, F. D., Massey, R. C., Grilo, I. R., Sobral, R., Larsen, J., Rhod Larsen, A., Vingsbo Lundberg, C. & 5 others, Parkhill, J., Paterson, G. K., Holden, M. T. G., Peacock, S. J. & Holmes, M. A., 24 Jun 2019, In : Nature Microbiology. 15 p.

    Research output: Contribution to journalArticle

  3. Atlas of group A streptococcal vaccine candidates compiled using large-scale comparative genomics

    Davies, M. R., McIntyre, L., Mutreja, A., Lacey, J. A., Lees, J. A., Towers, R. J., Duchêne, S., Smeesters, P. R., Frost, H. R., Price, D. J., Holden, M. T. G., David, S., Giffard, P. M., Worthing, K. A., Seale, A. C., Berkley, J. A., Harris, S. R., Rivera-Hernandez, T., Berking, O., Cork, A. J. & 18 others, Torres, R. S. L. A., Lithgow, T., Strugnell, R. A., Bergmann, R., Nitsche-Schmitz, P., Chhatwal, G. S., Bentley, S. D., Fraser, J. D., Moreland, N. J., Carapetis, J. R., Steer, A. C., Parkhill, J., Saul, A., Williamson, D. A., Currie, B. J., Tong, S. Y. C., Dougan, G. & Walker, M. J., Jun 2019, In : Nature Genetics. 51, 6, p. 1035-1043

    Research output: Contribution to journalArticle

  4. Antimicrobial resistance in atopic dermatitis: need for an urgent rethink

    Harkins, C. P., Holden, M. T. G. & Irvine, A. D., Mar 2019, In : Annals of Allergy Asthma & Immunology. 122, 3, p. 236-240 5 p.

    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. & 30 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. & REALITY Trial Team, 1 Apr 2018, In : Clinical Infectious Diseases. 66, Issue suppl_2, 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

ID: 249970513

Top