Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10337
Title: Tracing melioidosis back to the source: using whole-genome sequencing to investigate an outbreak originating from a contaminated domestic water supply.
Authors: McRobb, Evan
Sarovich, Derek S
Price, Erin P
Kaestli, Mirjam
Mayo, Mark
Keim, Paul
Currie, Bart J
Affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia..
Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia..
Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia..
Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia..
Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia..
Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, USA..
Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia Department of Infectious Diseases and Northern Territory Medical Program, Royal Darwin Hospital, Darwin, Northern Territory, Australia bart.currie@menzies.edu.au..
Issue Date: Apr-2015
Citation: Journal of clinical microbiology 2015-04; 53(4): 1144-8
Abstract: Melioidosis, a disease of public health importance in Southeast Asia and northern Australia, is caused by the Gram-negative soil bacillus Burkholderia pseudomallei. Melioidosis is typically acquired through environmental exposure, and case clusters are rare, even in regions where the disease is endemic. B. pseudomallei is classed as a tier 1 select agent by the Centers for Disease Control and Prevention; from a biodefense perspective, source attribution is vital in an outbreak scenario to rule out a deliberate release. Two cases of melioidosis within a 3-month period at a residence in rural northern Australia prompted an investigation to determine the source of exposure. B. pseudomallei isolates from the property's groundwater supply matched the multilocus sequence type of the clinical isolates. Whole-genome sequencing confirmed the water supply as the probable source of infection in both cases, with the clinical isolates differing from the likely infecting environmental strain by just one single nucleotide polymorphism (SNP) each. For the first time, we report a phylogenetic analysis of genomewide insertion/deletion (indel) data, an approach conventionally viewed as problematic due to high mutation rates and homoplasy. Our whole-genome indel analysis was concordant with the SNP phylogeny, and these two combined data sets provided greater resolution and a better fit with our epidemiological chronology of events. Collectively, this investigation represents a highly accurate account of source attribution in a melioidosis outbreak and gives further insight into a frequently overlooked reservoir of B. pseudomallei. Our methods and findings have important implications for outbreak source tracing of this bacterium and other highly recombinogenic pathogens.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10337
DOI: 10.1128/JCM.03453-14
ORCID: http://orcid.org/0000-0002-6944-3980
http://orcid.org/0000-0002-1079-4882
Type: Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Subjects: Burkholderia pseudomallei
Contact Tracing
Genome, Bacterial
Humans
Melioidosis
Molecular Sequence Data
Molecular Typing
Polymorphism, Single Nucleotide
Sequence Analysis, DNA
Water Supply
Disease Outbreaks
Water Microbiology
Appears in Collections:NT Health digital library

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