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Invasive group A streptococcal (iGAS) disease cases increased in the first half of 2022 in the Netherlands, with a remarkably high proportion of 4 isolates. Whole-genome sequence analysis of 66 4 isolates, 40 isolates from the pre-coronavirus disease 2019 (COVID-19) pandemic period 2009-2019 and 26 contemporary isolates from 2022, identified a novel lineage (M4), which accounted for 85 % of 4 iGAS cases in 2022. Surprisingly, we detected few isolates of the 4 hypervirulent clone, which has replaced nearly all other 4 in the USA and the UK.

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