Abstract
Whole genome microbial sequencing provides information at a level of resolution previously unattainable with the molecular biology techniques that have long served as tools for investigating transmission. In the past five years, sequencing has become an indispensable tool for investigating outbreaks on all scales, from local hospital clusters to pandemics. As sequencing platforms and bioinformatics analysis become faster and more accessible, real-time whole genome sequencing is increasingly integral to the fields of public health and hospital epidemiology. The infection control and public health communities must devise ways to translate real-time sequence data into real-time action that can change the course of an outbreak.
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International Human Genome Sequencing C. Finishing the euchromatic sequence of the human genome. Nature. 2004;431(7011):931–45.
Liu L, Li Y, Li S, et al. Comparison of next-generation sequencing systems. J Biomed Biotechnol. 2012;2012:251364.
Metzker ML. Sequencing technologies – the next generation. Nat Rev Genet. 2010;11(1):31–46.
Baker M. De novo genome assembly: what every biologist should know. Nat Methods. 2012;9(4):333–7.
Roberts RJ, Carneiro MO, Schatz MC. The advantages of SMRT sequencing. Genome Biol. 2013;14(7):405.
Conlan S, Thomas PJ, Deming C, et al. Single-molecule sequencing to track plasmid diversity of hospital-associated carbapenemase-producing Enterobacteriaceae. Sci Transl Med. 2014;6(254):254ra126.
Tenover FC, Arbeit RD, Goering RV, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol. 1995;33(9):2233–9.
van Belkum A. DNA fingerprinting of medically important microorganisms by use of PCR. Clin Microbiol Rev. 1994;7(2):174–84.
Larsen AR, Goering R, Stegger M, et al. Two distinct clones of methicillin-resistant Staphylococcus aureus (MRSA) with the same USA300 pulsed-field gel electrophoresis profile: a potential pitfall for identification of USA300 community-associated MRSA. J Clin Microbiol. 2009;47(11):3765–8.
Larsen MV, Cosentino S, Rasmussen S, et al. Multilocus sequence typing of total-genome-sequenced bacteria. J Clin Microbiol. 2012;50(4):1355–61.
National Human Genome Research Institute. Data from the NHGRI Genome Sequencing Program (GSP). Available at: https://www.genome.gov/sequencingcostsdata/. Accessed 2 Feb 2017.
Dekker JP, Frank KM. Next-generation epidemiology: using real-time core genome multilocus sequence typing to support infection control policy. J Clin Microbiol. 2016;54(12):2850–3.
Kluytmans-van den Bergh MF, Rossen JW, Bruijning-Verhagen PC, et al. Whole-genome multilocus sequence typing of extended-spectrum-beta-lactamase-producing Enterobacteriaceae. J Clin Microbiol. 2016;54(12):2919–27.
Snitkin ES, Zelazny AM, Thomas PJ, et al. Tracking a hospital outbreak of carbapenem-resistant Klebsiella pneumoniae with whole-genome sequencing. Sci Transl Med. 2012;4:148ra16.
Bottichio L, Medus C, Sorenson A, et al. Outbreak of salmonella Oslo infections linked to Persian cucumbers – United States, 2016. MMWR Morb Mortal Wkly Rep. 2016;65(5051):1430–3.
Weiss D, Boyd C, Rakeman JL, et al. A large community outbreak of Legionnaires’ disease associated with a cooling tower in New York City, 2015. Public Health Rep. 2017;132(2):241–50.
Chen L, Chavda KD, Melano RG, et al. Comparative genomic analysis of KPC-encoding pKpQIL-like plasmids and their distribution in New Jersey and New York Hospitals. Antimicrob Agents Chemother. 2014;58(5):2871–7.
Mathers AJ, Cox HL, Kitchel B, et al. Molecular dissection of an outbreak of carbapenem-resistant enterobacteriaceae reveals Intergenus KPC carbapenemase transmission through a promiscuous plasmid. MBio. 2011;2(6):e00204–11.
Qin J, Cui Y, Zhao X, et al. Identification of the Shiga toxin-producing Escherichia coli O104:H4 strain responsible for a food poisoning outbreak in Germany by PCR. J Clin Microbiol. 2011;49(9):3439–40.
Yang JY, Brooks S, Meyer JA, et al. Pan-PCR, a computational method for designing bacterium-typing assays based on whole-genome sequence data. J Clin Microbiol. 2013;51(3):752–8.
Jenson D, Szabo V, Duke FHIHHLSRT. Cholera in Haiti and other Caribbean regions, 19th century. Emerg Infect Dis. 2011;17(11):2130–5.
Mutreja A, Kim DW, Thomson NR, et al. Evidence for several waves of global transmission in the seventh cholera pandemic. Nature. 2011;477(7365):462–5.
Chin CS, Sorenson J, Harris JB, et al. The origin of the Haitian cholera outbreak strain. N Engl J Med. 2011;364(1):33–42.
Eppinger M, Pearson T, Koenig SS, et al. Genomic epidemiology of the Haitian cholera outbreak: a single introduction followed by rapid, extensive, and continued spread characterized the onset of the epidemic. MBio. 2014;5(6):e01721.
Katz JM. The U.N.’s cholera admission and what comes next. New York Times Magazine. 2016 August 19. 2016.
Satoh K, Makimura K, Hasumi Y, Nishiyama Y, Uchida K, Yamaguchi H. Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiol Immunol. 2009;53(1):41–4.
Lockhart SR, Etienne KA, Vallabhaneni S, et al. Simultaneous emergence of multidrug-resistant Candida auris on 3 continents confirmed by whole-genome sequencing and epidemiological analyses. Clin Infect Dis. 2017;64(2):134–40.
Vallabhaneni S, Kallen A, Tsay S, et al. Investigation of the first seven reported cases of Candida auris, a globally emerging invasive, multidrug-resistant fungus – United States, May 2013-August 2016. MMWR Morb Mortal Wkly Rep. 2016;65(44):1234–7.
Centers for Disease Control and Prevention. Candida auris. Available at: https://www.cdc.gov/fungal/diseases/candidiasis/candida-auris.html. Accessed 20 Mar 2017.
Koser CU, Holden MT, Ellington MJ, et al. Rapid whole-genome sequencing for investigation of a neonatal MRSA outbreak. N Engl J Med. 2012;366(24):2267–75.
Schlebusch S, Price GR, Gallagher RL, et al. MALDI-TOF MS meets WGS in a VRE outbreak investigation. Eur J Clin Microbiol Infect Dis. 2017;36(3):495–9.
Jimenez A, Castro JG, Munoz-Price LS, et al. Outbreak of Klebsiella pneumoniae carbapenemase-producing Citrobacter freundii at a tertiary acute care facility in Miami. Fla Infect Control Hosp Epidemiol. 2017;38(3):320–6.
Jauneikaite E, Khan-Orakzai Z, Kapatai G, et al. Nosocomial outbreak of drug-resistant Streptococcus pneumoniae serotype 9V in an adult respiratory medicine ward. J Clin Microbiol. 2017;55(3):776–82.
Hagiya H, Aoki K, Akeda Y, et al. Nosocomial transmission of carbapenem-resistant Klebsiella pneumoniae elucidated by single-nucleotide variation analysis: a case investigation. Infection. 2017;45:221–5.
Sabat AJ, Hermelijn SM, Akkerboom V, et al. Complete-genome sequencing elucidates outbreak dynamics of CA-MRSA USA300 (ST8-spa t008) in an academic hospital of Paramaribo, Republic of Suriname. Sci Rep. 2017;7:41050.
Weterings V, Zhou K, Rossen JW, et al. An outbreak of colistin-resistant Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae in the Netherlands (July to December 2013), with inter-institutional spread. Eur J Clin Microbiol Infect Dis. 2015;34(8):1647–55.
Marsh JW, Krauland MG, Nelson JS, et al. Genomic epidemiology of an endoscope-associated outbreak of Klebsiella pneumoniae Carbapenemase (KPC)-producing K. pneumoniae. PLoS One. 2015;10(12):e0144310.
Skalova A, Chudejova K, Rotova V, et al. Molecular characterization of OXA-48-like-producing enterobacteriaceae in the Czech Republic and evidence for horizontal transfer of pOXA-48-like plasmids. Antimicrob Agents Chemother. 2017;61(2):e01889–16.
Mathers AJ, Stoesser N, Sheppard AE, et al. Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae at a single institution: insights into endemicity from whole-genome sequencing. Antimicrob Agents Chemother. 2015;59(3):1656–63.
Popovich KJ, Snitkin E, Green SJ, et al. Genomic epidemiology of USA300 methicillin-resistant Staphylococcus aureus in an urban community. Clin Infect Dis. 2016;62(1):37–44.
Pecora ND, Li N, Allard M, et al. Genomically informed surveillance for carbapenem-resistant Enterobacteriaceae in a health care system. MBio. 2015;6(4):e01030.
Zhou K, Lokate M, Deurenberg RH, et al. Use of whole-genome sequencing to trace, control and characterize the regional expansion of extended-spectrum beta-lactamase producing ST15 Klebsiella pneumoniae. Sci Rep. 2016;6:20840.
Gupta N, Limbago BM, Patel JB, Kallen AJ. Carbapenem-resistant Enterobacteriaceae: epidemiology and prevention. Clin Infect Dis. 2011;53(1):60–7.
Leavitt A, Navon-Venezia S, Chmelnitsky I, Schwaber MJ, Carmeli Y. Emergence of KPC-2 and KPC-3 in carbapenem-resistant Klebsiella pneumoniae strains in an Israeli hospital. Antimicrob Agents Chemother. 2007;51(8):3026–9.
Del Franco M, Paone L, Novati R, et al. Molecular epidemiology of carbapenem resistant Enterobacteriaceae in Valle d’Aosta region, Italy, shows the emergence of KPC-2 producing Klebsiella pneumoniae clonal complex 101 (ST101 and ST1789). BMC Microbiol. 2015;15(1):260.
Norheim G, Seterelv S, Arnesen TM, et al. Tuberculosis outbreak in an educational institution in Norway. J Clin Microbiol. 2017;55:1327–33.
Walker TM, Ip CL, Harrell RH, et al. Whole-genome sequencing to delineate Mycobacterium tuberculosis outbreaks: a retrospective observational study. Lancet Infect Dis. 2013;13(2):137–46.
Gardy JL, Johnston JC, Ho Sui SJ, et al. Whole-genome sequencing and social-network analysis of a tuberculosis outbreak. N Engl J Med. 2011;364:730–9.
Bryant JM, Grogono DM, Greaves D, et al. Whole-genome sequencing to identify transmission of Mycobacterium abscessus between patients with cystic fibrosis: a retrospective cohort study. Lancet. 2013;381(9877):1551–60.
Harris KA, Underwood A, Kenna DT, et al. Whole-genome sequencing and epidemiological analysis do not provide evidence for cross-transmission of mycobacterium abscessus in a cohort of pediatric cystic fibrosis patients. Clin Infect Dis. 2015;60(7):1007–16.
Chand M, Lamagni T, Kranzer K, et al. Insidious risk of severe Mycobacterium chimaera infection in cardiac surgery patients. Clin Infect Dis. 2017;64(3):335–42.
Kohler P, Kuster SP, Bloemberg G, et al. Healthcare-associated prosthetic heart valve, aortic vascular graft, and disseminated Mycobacterium chimaera infections subsequent to open heart surgery. Eur Heart J. 2015;36(40):2745–53.
Svensson E, Jensen ET, Rasmussen EM, Folkvardsen DB, Norman A, Lillebaek T. Mycobacterium chimaera in heater-cooler units in Denmark related to isolates from the United States and United Kingdom. Emerg Infect Dis. 2017;23(3):507–9.
Sax H, Bloemberg G, Hasse B, et al. Prolonged outbreak of Mycobacterium chimaera infection after open-chest heart surgery. Clin Infect Dis. 2015;61(1):67–75.
Schreiber PW, Kuster SP, Hasse B, et al. Reemergence of Mycobacterium chimaera in heater-cooler units despite intensified cleaning and disinfection protocol. Emerg Infect Dis. 2016;22(10):1830–3.
Perkins KM, Lawsin A, Hasan NA, et al. Notes from the field: mycobacterium chimaera contamination of heater-cooler devices used in cardiac surgery – United States. MMWR Morb Mortal Wkly Rep. 2016;65(40):1117–8.
Robinson JO, Coombs GW, Speers DJ, et al. Mycobacterium chimaera colonisation of heater-cooler units (HCU) in Western Australia, 2015: investigation of possible iatrogenic infection using whole genome sequencing. Euro Surveill. 2016;21(46):pii=30396.
Haller S, Holler C, Jacobshagen A, et al. Contamination during production of heater-cooler units by Mycobacterium chimaera potential cause for invasive cardiovascular infections: results of an outbreak investigation in Germany, April 2015 to February 2016. Euro Surveill. 2016;21(17):pii=30215.
Kanamori H, Weber DJ, Rutala WA. Healthcare-associated Mycobacterium chimaera transmission and infection prevention challenges: role of heater-cooler units as a water source in cardiac surgery. Clin Infect Dis. 2017;64(3):343–6.
Chen Y, Luo Y, Curry P, et al. Assessing the genome level diversity of Listeria monocytogenes from contaminated ice cream and environmental samples linked to a listeriosis outbreak in the United States. PLoS One. 2017;12(2):e0171389.
Jackson KA, Stroika S, Katz LS, et al. Use of whole genome sequencing and patient interviews to link a case of sporadic Listeriosis to consumption of prepackaged lettuce. J Food Prot. 2016;79(5):806–9.
Zoufaly A, Cramer JP, Vettorazzi E, et al. Risk factors for development of hemolytic uremic syndrome in a cohort of adult patients with STEC 0104:H4 infection. PLoS One. 2013;8(3):e59209.
Rohde H, Qin J, Cui Y, et al. Open-source genomic analysis of shiga-toxin-producing E. coli O104:H4. N Engl J Med. 2011;365(8):718–24.
Jackson BR, Tarr C, Strain E, et al. Implementation of nationwide real-time whole-genome sequencing to enhance Listeriosis outbreak detection and investigation. Clin Infect Dis. 2016;63(3):380–6.
Mellmann A, Bletz S, Boking T, et al. Real-time genome sequencing of resistant bacteria provides precision infection control in an institutional setting. J Clin Microbiol. 2016;54(12):2874–81.
Davis-Turak J, Courtney SM, Hazard ES, et al. Genomics pipelines and data integration: challenges and opportunities in the research setting. Expert Rev Mol Diagn. 2017;17(3):225–37.
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This work was supported by the Intramural Research Program of the NIH Clinical Center.
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Palmore, T.N. (2018). Whole Genome Sequencing for Outbreak Investigation. In: Bearman, G., Munoz-Price, S., Morgan, D., Murthy, R. (eds) Infection Prevention. Springer, Cham. https://doi.org/10.1007/978-3-319-60980-5_20
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DOI: https://doi.org/10.1007/978-3-319-60980-5_20
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