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Infect Control Hosp Epidemiol. 2015 Sep;36(9):1058-64. doi: 10.1017/ice.2015.133. Epub 2015 Jun 8.

Whole Genome Sequencing in Real-Time Investigation and Management of a Pseudomonas aeruginosa Outbreak on a Neonatal Intensive Care Unit.

Author information

1
1Department of Infectious Diseases and Microbiology,Royal Prince Alfred Hospital,Sydney NSW Australia.
2
2Molecular Medicine Research Group,School of Medicine,University of Western Sydney,Sydney NSW Australia.
3
4Department of Perinatal Medicine,Royal Prince Alfred Hospital,Sydney NSW Australia.

Abstract

OBJECTIVE:

To use whole genome sequencing to describe the likely origin of an outbreak of Pseudomonas aeruginosa in a neonatal unit.

DESIGN:

Outbreak investigation.

SETTING:

The neonatal intensive care unit service of a major obstetric tertiary referral center.

PATIENTS:

Infants admitted to the neonatal unit who developed P. aeruginosa colonization or infection.

METHODS:

We undertook whole genome sequencing of P. aeruginosa strains isolated from colonized infants and from the neonatal unit environment.

RESULTS:

Eighteen infants were colonized with P. aeruginosa. Isolates from 12 infants and 7 environmental samples were sequenced. All but one of the clinical isolates clustered in ST253 and no differences were detected between unmapped reads. The environmental isolates revealed a variety of sequence types, indicating a large diverse bioburden within the unit, which was subsequently confirmed via enterobacterial repetitive intergenic consensus-polymerase chain reaction typing of post-outbreak isolates. One environmental isolate, obtained from a sink in the unit, clustered within ST253 and differed from the outbreak strain by 9 single-nucleotide polymorphisms only. This information allowed us to focus infection control activities on this sink.

CONCLUSIONS:

Whole genome sequencing can provide detailed information in a clinically relevant time frame to aid management of outbreaks in critical patient management areas. The superior discriminatory power of this method makes it a powerful tool in infection control.

PMID:
26050101
DOI:
10.1017/ice.2015.133
[Indexed for MEDLINE]

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