Determination of emm type for Streptococcus pyogenes by PCR

The determination of emm type for Streptococcus pyogenes.

Pure culture, presumptively identified as S. pyogenes, isolated from a normally sterile site (blood, CSF, pleural fluid, pericardial fluid, peritoneal fluid, deep tissue specimen, bone or joint fluid excluding middle ear and superficial wound aspirates).

Specimens may be subject to rejection if they are not the appropriate sample type, a duplicate sample**, have insufficient volume, are not accompanied by relevant patient information, not on the correct requisition, or requisition is absent.

Isolate provided on culture medium.

Send as growth on culture medium or on a swab in transport medium.  Chocolate or charcoal media are recommended.  Cultures can be also shipped frozen on dry ice. 

Shipping of specimens shall be done by a TDG certified individual in accordance with TDG regulations. For additional information regarding classification of specimens for the purposes of shipping, consult either Part 2 Appendix 3 of the TDG Regulations or section 3.6.2 of the IATA Dangerous Goods Regulations as applicable.

Invasive disease due to Streptococcus pyogenes.

Completed Isolate Submission Requisition for Streptococcus form including sender lab name, address, telephone number and email address. Patient age or date of birth, sex, culture reference number, clinical source, date collected and test requested. Outbreak or specimens requiring expedited testing or phylogenetic analysis must be indicated as such on the requisition. The above information must be sent as a hardcopy with the shipment, and an excel file may be sent to nml.strepsti-lnm.strepits@phac-aspc.gc.ca.

Non-invasive isolates of Streptococcus pyogenes that are related to outbreak investigations may be submitted.

**Duplicate samples should not be submitted without prior consent as they may not be processed. Isolates collected from the same patient within 3 weeks are considered duplicates.

*emm typing using whole genome sequencing (primary) (3,4)

emm typing using polymerase chain reaction (secondary) (1)

30 calendar days.

Outbreak associated or urgent isolates will be granted priority status and completed as soon as possible.

***Turn around times may not be guaranteed when isolates are submitted in large batches.

1. Beall, Bernard, Gherardi, G., Lovgren, M., Facklam R.R., Forwick B.A. and Tyrrell, G.J. emm and sof gene sequence variation in relation to serological typing of opacity-factor-positive group A streptococci. Microbiology 2000;146:1195-1209.
2. Centers for Disease Control and Prevention, Streptococcus Laboratory.  Streptococcus Laboratory Protocols. Available at http://www.cdc.gov./ncidod/biotech/strep/protocols.htm.
3. Athey TBT, Teatero S, Li A, Marchand-Austin A, Beall BW, Fittipaldi N. Deriving group A streptococcus typing information from short-read whole-genome sequencing data. J Clin Microbiol. 2014;52(6):1871–1876.
4. Kapatai G, Coelho J, Platt S, Chalker VJ. Whole genome sequencing of group A streptococcus: development and evaluation of an automated pipeline for emm gene typing. PeerJ. 2017;5:e3226.