ArticleJournal of clinical microbiology2014
Clinical laboratory response to a mock outbreak of invasive bacterial infections: a preparedness study.
Article in Journal of clinical microbiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Disparate Effects of Invasive Group A Streptococcus on Native Americans.Emerging infectious diseases · 2020Article
- Human Infections Caused by Clonally Related African Clade (Clade III) Strains of Candida auris in the Greater Houston Region.Journal of clinical microbiology · 2020Article
- Postpartum Group A Streptococcus Case Series: Reach Out to Infection Prevention!Open forum infectious diseases · 2018Article
- Canada-Wide Epidemic ofOpen forum infectious diseases · 2018Article
- Developing an in silico minimum inhibitory concentration panel test for Klebsiella pneumoniae.Scientific reports · 2018Article
- Genome sequence analysis of emm89 Streptococcus pyogenes strains causing infections in Scotland, 2010-2016.Journal of medical microbiology · 2017Article
- Bacterial genome sequencing in clinical microbiology: a pathogen-oriented review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Review
- Importance of whole genome sequencing for the assessment of outbreaks in diagnostic laboratories: analysis of a case series of invasive Streptococcus pyogenes infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Article
- Article
- Genomic Landscape of Intrahost Variation in Group A Streptococcus: Repeated and Abundant Mutational Inactivation of the fabT Gene Encoding a Regulator of Fatty Acid Synthesis.Infection and immunity · 2016Article
- Article
- Hypervirulent emm59 Clone in Invasive Group A Streptococcus Outbreak, Southwestern United States.Emerging infectious diseases · 2016Article
- High Incidence of Invasive Group A Streptococcus Disease Caused by Strains of Uncommon emm Types in Thunder Bay, Ontario, Canada.Journal of clinical microbiology · 2016Article
- The majority of 9,729 group A streptococcus strains causing disease secrete SpeB cysteine protease: pathogenesis implications.Infection and immunity · 2015Article
- Improving American Healthcare Through "Clinical Lab 2.0": A Project Santa Fe Report.Academic pathologyArticle
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Large hospital-based clinical laboratories must be prepared to rapidly investigate potential infectious disease outbreaks. To challenge the ability of our molecular diagnostics laboratory to use whole-genome sequencing in a potential outbreak scenario and identify impediments to these efforts, we studied 84 invasive serotype emm59 group A streptococcus (GAS) strains collected in the United States. We performed a rapid-response exercise to the mock outbreak scenario using whole-genome sequencing, genome-wide transcript analysis, and mouse virulence studies. The protocol changes installed in response to the lessons learned were tested in a second iteration. The initial investigation was completed in 9 days. Whole-genome sequencing showed that the invasive infections were caused by multiple subclones of epidemic emm59 GAS strains likely spread to the United States from Canada. The phylogenetic tree showed a strong temporal-spatial structure with diversity in mobile genetic element content, features that are useful for identifying closely related strains and possible transmission events. The genome data informed the epidemiology, identifying multiple patients who likely acquired the organisms through direct person-to-person transmission. Transcriptome analysis unexpectedly revealed significantly altered expression of genes encoding a two-component regulator and the hyaluronic acid capsule virulence factor. Mouse infection studies confirmed a high-virulence capacity of these emm59 organisms. Whole-genome sequencing, coupled with transcriptome analysis and animal virulence studies, can be rapidly performed in a clinical environment to effectively contribute to patient care decisions and public health maneuvers.
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