Streptococcus pyogenes Surveillance Through Surface Swab Samples to Track the Emergence of Streptococcal Toxic Shock Syndrome in Rural Japan

Japan recently experienced a record surge in streptococcal toxic shock syndrome. Our environmental surveillance study reveals that Streptococcus pyogenes persists seasonally, peaking in autumn and winter in rural Japan. The dominant emm1 M1UK sublineage and csrS mutations heighten virulence, highlighting the urgent need for targeted surveillance and interventions.