@article{1723520487f748f18e53352685c1312a,
title = "Rapid selection of complement-inhibiting protein variants in group a Streptococcus epidemic waves",
abstract = "Serotype M1 group A Streptococcus strains cause epidemic waves of human infections long thought to be mono- or pauciclonal. The gene encoding an extracellular group A Streptococcus protein (streptococcal inhibitor of complement) that inhibits human complement was sequenced in 1,132 M1 strains recovered from population-based surveillance of infections in Canada, Finland and the United States. Epidemic waves are composed of strains expressing a remarkably heterogeneous array of variants of streptococcal inhibitor of complement that arise very rapidly by natural selection on mucosal surfaces. Thus, our results enhance the understanding of pathogen population dynamics in epidemic waves and infectious disease reemergence.",
author = "Hoe, {Nancy P.} and Kazumitsu Nakashima and Slawomir Lukomski and Diana Grigsby and Mengyao Liu and Parichher Kordari and Dou, {Shu Jun} and Xi Pan and Jaana Vuopio-Varkila and Saara Salmelinna and Allison McGeer and Low, {Donald E.} and Benjamin Schwartz and Anne Schuchat and Steven Naidich and {De Lorenzo}, Dsvid and Fu, {Yun Xin} and Musser, {James M.}",
note = "Funding Information: Acknowledgments We thank W.A. Keitel and J. Dale for critical reading of the manuscript, R.S. Orkiszewski for the mass spectroscopy analysis, I. Eckstrand for support, and S. Ruusunen, R. Scotford and E. Siren for technical assistance. We thank A. Muotiala, H. Seppala, P. Huovinen and the Finnish Study Group for Antimicrobial Resistance for their work and support during collection of the Finnish strains. Specimens from the United States were provided by the Emerging Infections Program Network/Active Bacterial Core Surveillance, supported by a cooperative agreement between the Centers for Disease Control and Prevention and the State Health Departments of California, Connecticut, Georgia, and Minnesota. This study was supported by United States Public Health Service Grants AI-33119 to J.M.M. and GM-50428 to Y.-X. F., and the Canadian Bacterial Disease Network.",
year = "1999",
month = aug,
doi = "10.1038/11369",
language = "English (US)",
volume = "5",
pages = "924--929",
journal = "Nature Medicine",
issn = "1078-8956",
publisher = "Nature Research",
number = "8",
}