FIG 3 .

Rise of the emergent clade to dominance in the United Kingdom emm89 population. Between 2004 and 2007, the United Kingdom was represented by a diverse emm89 population (blue line, left axis); however, there was a sudden switch between 2007 and 2008 and the emergent clade-associated emm89 variant (red line, left axis) became the dominating type in the population. The rise of the emergent clade coincided with an increase in the frequency of emm89 iGAS in the United Kingdom (gray dotted line, right axis). Association with the emergent clade was determined by WGS of 126 emm89 strains (excluding pairs of strains isolated from the same patient) isolated in 2004 to 2013 (n = 10 for 2005, 2006, 2007, 2011, and 2013; n = 11 for 2004 and 2008; n = 28 for 2009; n = 17 for 2010; n = 9 for 2012).