Local Genomic Surveillance of Invasive Streptococcus pyogenes in Eastern North Carolina (ENC) in 2022-2023.

The recent increase in Group A Streptococcus (GAS) incidences in several countries across Europe and some areas of the Unites States (U.S.) has raised concerns. To understand GAS diversity and prevalence, we conducted a local genomic surveillance in Eastern North Carolina (ENC) in 2022-2023 with 95 isolates and compared its results to those of the existing national genomic surveillance in the U.S. in 2015-2021 with 13,064 isolates. We observed their epidemiological changes before and during the COVID-19 pandemic and detected a unique sub-lineage in ENC among the most common invasive GAS strain, ST28/emm1. We further discovered a multiple-copy insertion sequence, ISLgar5, in ST399/emm77 and its single-copy variants in some other GAS strains. We discovered ISLgar5 was linked to a Tn5801-like tetM-carrying integrative and conjugative element, and its copy number was associated with an ermT-carrying pRW35-like plasmid. The dynamic insertions of ISLgar5 may play a vital role in genome fitness and adaptation, driving GAS evolution relevant to antimicrobial resistance and potentially GAS virulence.

Ten steps to increase library impact on an academic health sciences campus.

In summer 2009, the Norris Medical Library decided to increase outreach efforts in an attempt to revitalize its role in the USC School of Pharmacy for the upcoming academic year. Active networking in the summer and early fall resulted in an increase in use of both educational and reference services by pharmacy students and faculty; the number of planned instruction sessions for the 2009-2010 academic year increased fivefold. This article identifies ten steps that allowed the Library to expand its role considerably in just a few months. If followed wholly, or in part, these ten steps will help any library become more involved on a health sciences campus.