Streptococcus pyogenes Is Associated with Idiopathic Cutaneous Ulcers in Children on a Yaws-Endemic Island

dc.contributor.authorGriesenauer, Brad
dc.contributor.authorGonzález-Beiras, Camila
dc.contributor.authorFortney, Katherine R.
dc.contributor.authorLin, Huaiying
dc.contributor.authorGao, Xiang
dc.contributor.authorGodornes, Charmie
dc.contributor.authorNelson, David E.
dc.contributor.authorKatz, Barry P.
dc.contributor.authorLukehart, Sheila A.
dc.contributor.authorMitjà, Oriol
dc.contributor.authorDong, Qunfeng
dc.contributor.authorSpinola, Stanley M.
dc.contributor.departmentMicrobiology and Immunology, School of Medicineen_US
dc.date.accessioned2022-05-18T15:54:48Z
dc.date.available2022-05-18T15:54:48Z
dc.date.issued2021-01-12
dc.description.abstractExudative cutaneous ulcers (CU) in yaws-endemic areas are associated with Treponema pallidum subsp. pertenue (TP) and Haemophilus ducreyi (HD), but one-third of CU cases are idiopathic (IU). Using mass drug administration (MDA) of azithromycin, a yaws eradication campaign on Lihir Island in Papua New Guinea reduced but failed to eradicate yaws; IU rates remained constant throughout the campaign. To identify potential etiologies of IU, we obtained swabs of CU lesions (n = 279) and of the skin of asymptomatic controls (AC; n = 233) from the Lihir Island cohort and characterized their microbiomes using a metagenomics approach. CU bacterial communities were less diverse than those of the AC. Using real-time multiplex PCR with pathogen-specific primers, we separated CU specimens into HD-positive (HD+), TP+, HD+TP+, and IU groups. Each CU subgroup formed a distinct bacterial community, defined by the species detected and/or the relative abundances of species within each group. Streptococcus pyogenes was the most abundant organism in IU (22.65%) and was enriched in IU compared to other ulcer groups. Follow-up samples (n = 31) were obtained from nonhealed ulcers; the average relative abundance of S. pyogenes was 30.11% in not improved ulcers and 0.88% in improved ulcers, suggesting that S. pyogenes in the not improved ulcers may be azithromycin resistant. Catonella morbi was enriched in IU that lacked S. pyogenes As some S. pyogenes and TP strains are macrolide resistant, penicillin may be the drug of choice for CU azithromycin treatment failures. Our study will aid in the design of diagnostic tests and selective therapies for CU.IMPORTANCE Cutaneous ulcers (CU) affect approximately 100,000 children in the tropics each year. While two-thirds of CU are caused by Treponema pallidum subspecies pertenue and Haemophilus ducreyi, the cause(s) of the remaining one-third is unknown. Given the failure of mass drug administration of azithromycin to eradicate CU, the World Health Organization recently proposed an integrated disease management strategy to control CU. Success of this strategy requires determining the unknown cause(s) of CU. By using 16S rRNA gene sequencing of swabs obtained from CU and the skin of asymptomatic children, we identified another possible cause of skin ulcers, Streptococcus pyogenes Although S. pyogenes is known to cause impetigo and cellulitis, this is the first report implicating the organism as a causal agent of CU. Inclusion of S. pyogenes into the integrated disease management plan will improve diagnostic testing and treatment of this painful and debilitating disease of children and strengthen elimination efforts.en_US
dc.eprint.versionFinal published versionen_US
dc.identifier.citationGriesenauer B, González-Beiras C, Fortney KR, et al. Streptococcus pyogenes Is Associated with Idiopathic Cutaneous Ulcers in Children on a Yaws-Endemic Island. mBio. 2021;12(1):e03162-20. Published 2021 Jan 12. doi:10.1128/mBio.03162-20en_US
dc.identifier.urihttps://hdl.handle.net/1805/29055
dc.language.isoen_USen_US
dc.publisherAmerican Society for Microbiologyen_US
dc.relation.isversionof10.1128/mBio.03162-20en_US
dc.relation.journalmBioen_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttps://creativecommons.org/licenses/by/4.0*
dc.sourcePMCen_US
dc.subjectHaemophilus ducreyien_US
dc.subjectStreptococcus pyogenesen_US
dc.subjectTreponema pallidum subsp. pertenueen_US
dc.subjectCutaneous ulcersen_US
dc.subjectMicrobiomeen_US
dc.titleStreptococcus pyogenes Is Associated with Idiopathic Cutaneous Ulcers in Children on a Yaws-Endemic Islanden_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
mBio.03162-20.pdf
Size:
2.03 MB
Format:
Adobe Portable Document Format
Description:
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.99 KB
Format:
Item-specific license agreed upon to submission
Description: