11 results on '"Morgan N. Schroeder"'
Search Results
2. Agritourism and Kidding Season: A Large Outbreak of Human Shiga Toxin-Producing Escherichia coli O157 (STEC O157) Infections Linked to a Goat Dairy Farm—Connecticut, 2016
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Megin C. Nichols, Paul Gacek, Quyen Phan, Kelly J. Gambino-Shirley, Lauren M. Gollarza, Morgan N. Schroeder, Alexandra Mercante, Jocelyn Mullins, Anna Blackstock, Mark E. Laughlin, Samantha M. Olson, Eugene Pizzo, Tu Ngoc Nguyen, Laurn Mank, Kimberly Holmes-Talbot, Alycia McNutt, Diane Noel, Anthony Muyombwe, Jafar H. Razeq, Mary Jane Lis, Bruce Sherman, Wayne Kasacek, Laura Whitlock, Nancy Strockbine, Haley Martin, Eshaw Vidyaprakash, Patrick McCormack, and Matthew Cartter
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E. coli–Escherichia coli ,goat ,outbreak ,agritourism ,diarrhea ,Shiga toxin (Stx) producing Escherichia coli (STEC) ,Veterinary medicine ,SF600-1100 - Abstract
The objective of this study was to determine sources of Shiga toxin-producing Escherichia coli O157 (STEC O157) infection among visitors to Farm X and develop public health recommendations. A case-control study was conducted. Case-patients were defined as the first ill child (aged
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- 2021
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3. Azithromycin and Ciprofloxacin Treatment Outcomes During an Outbreak of Multidrug-Resistant Shigella sonnei Infections in a Retirement Community—Vermont, 2018
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Kathleen E. Fullerton, Jennifer P Collins, Morgan N Schroeder, Zachary A Marsh, Ashutosh Wadhwa, Azizat A Adediran, Louise Francois Watkins, Radhika Gharpure, Jonathan Strysko, Elizabeth H Meservey, Veronica Fialkowski, Cindy R. Friedman, and Jessica C. Chen
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0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,030106 microbiology ,Shigella sonnei ,Microbial Sensitivity Tests ,Azithromycin ,medicine.disease_cause ,Article ,Disease Outbreaks ,03 medical and health sciences ,0302 clinical medicine ,Ciprofloxacin ,Ampicillin ,Internal medicine ,Drug Resistance, Bacterial ,Humans ,Medicine ,Shigella ,030212 general & internal medicine ,Dysentery, Bacillary ,Retirement ,business.industry ,Broth microdilution ,Anti-Bacterial Agents ,Diarrhea ,Treatment Outcome ,Infectious Diseases ,Ceftriaxone ,Macrolides ,medicine.symptom ,business ,Vermont ,medicine.drug - Abstract
Background In 2018, the Centers for Disease Control and Prevention and the Vermont Department of Health investigated an outbreak of multidrug-resistant Shigella sonnei infections in a retirement community that offered a continuum of care from independent living through skilled nursing care. The investigation identified 24 culture-confirmed cases. Isolates were resistant to trimethoprim-sulfamethoxazole, ampicillin, and ceftriaxone, and had decreased susceptibility to azithromycin and ciprofloxacin. Methods To evaluate clinical and microbiologic response, we reviewed inpatient and outpatient medical records for treatment outcomes among the 24 patients with culture-confirmed S. sonnei infection. We defined clinical failure as diarrhea (≥3 loose stools per day) for ≥1 day after treatment finished, and microbiologic failure as a stool culture that yielded S. sonnei after treatment finished. We used broth microdilution to perform antimicrobial susceptibility testing, and whole genome sequencing to identify resistance mechanisms. Results Isolates contained macrolide resistance genes mph(A) and erm(B) and had azithromycin minimum inhibitory concentrations above the Clinical and Laboratory Standards Institute epidemiological cutoff value of ≤16 µg/mL. Among 24 patients with culture-confirmed Shigella infection, 4 were treated with azithromycin; all had clinical treatment failure and 2 also had microbiologic treatment failure. Isolates were susceptible to ciprofloxacin but contained a gyrA mutation; 2 patients failed treatment with ciprofloxacin. Conclusions These azithromycin treatment failures demonstrate the importance of clinical breakpoints to aid clinicians in identifying alternative treatment options for resistant strains. Additionally, these treatment failures highlight a need for comprehensive susceptibility testing and systematic outcome studies, particularly given the emergence of multidrug-resistant Shigella among an expanding range of patient populations.
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- 2021
4. Shiga Toxin–Producing Escherichia coli Infections Associated With Romaine Lettuce—United States, 2018
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June Nash, Adiam Tesfai, Amanda Tiffany, Lyndsay Bottichio, Bozena M. Morawski, Amelia Keaton, Morgan N Schroeder, Amber Barnes, Deepam Thomas, Mark Otto, Anna Frick, Matthew E. Wise, Haley Martin, Kelly E. Kline, Laura Gieraltowski, Susan Lance, Jennifer L. Murphy, Colin Basler, Vincent R. Hill, Ian T. Williams, Kane Patel, Jeffrey Higa, Lori M. Gladney, Natasha Dowell, Wendy Taylor, Corinne Newhart, Angela Fields, Tara Fulton, Jennifer Fiddner, April Holland, Rachel Hinnenkamp, Francine Arroyo, Annabelle Salvatierra, Louise Francois Watkins, Sarah Correll, Laura Whitlock, Jeffrey Havens, Amy M. Kahler, Stic Harris, and Mia C Mattioli
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0301 basic medicine ,Microbiology (medical) ,Veterinary medicine ,030106 microbiology ,Escherichia coli O157 ,medicine.disease_cause ,Disease cluster ,Disease Outbreaks ,Foodborne Diseases ,Food and drug administration ,03 medical and health sciences ,Humans ,Medicine ,Shiga toxin-producing Escherichia coli ,Escherichia coli ,Escherichia coli Infections ,Disease surveillance ,Shiga-Toxigenic Escherichia coli ,business.industry ,Pulsenet ,Outbreak ,Lettuce ,Pennsylvania ,United States ,030104 developmental biology ,Infectious Diseases ,Food Microbiology ,business ,National laboratory - Abstract
Background Produce-associated outbreaks of Shiga toxin–producing Escherichia coli (STEC) were first identified in 1991. In April 2018, New Jersey and Pennsylvania officials reported a cluster of STEC O157 infections associated with multiple locations of a restaurant chain. The Centers for Disease Control and Prevention (CDC) queried PulseNet, the national laboratory network for foodborne disease surveillance, for additional cases and began a national investigation. Methods A case was defined as an infection between 13 March and 22 August 2018 with 1 of the 22 identified outbreak-associated E. coli O157:H7 or E. coli O61 pulsed-field gel electrophoresis pattern combinations, or with a strain STEC O157 that was closely related to the main outbreak strain by whole-genome sequencing. We conducted epidemiologic and traceback investigations to identify illness subclusters and common sources. A US Food and Drug Administration–led environmental assessment, which tested water, soil, manure, compost, and scat samples, was conducted to evaluate potential sources of STEC contamination. Results We identified 240 case-patients from 37 states; 104 were hospitalized, 28 developed hemolytic uremic syndrome, and 5 died. Of 179 people who were interviewed, 152 (85%) reported consuming romaine lettuce in the week before illness onset. Twenty subclusters were identified. Product traceback from subcluster restaurants identified numerous romaine lettuce distributors and growers; all lettuce originated from the Yuma growing region. Water samples collected from an irrigation canal in the region yielded the outbreak strain of STEC O157. Conclusions We report on the largest multistate leafy greens–linked STEC O157 outbreak in several decades. The investigation highlights the complexities associated with investigating outbreaks involving widespread environmental contamination.
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- 2019
5. Agritourism and Kidding Season: A Large Outbreak of Human Shiga Toxin-Producing Escherichia coli O157 (STEC O157) Infections Linked to a Goat Dairy Farm—Connecticut, 2016
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Paul Gacek, Anthony Muyombwe, Matthew L. Cartter, Jafar Razeq, Mary Jane Lis, Lauren M. Gollarza, Morgan N Schroeder, Nancy Strockbine, Tu Ngoc Nguyen, Eshaw Vidyaprakash, Bruce Sherman, Mark E. Laughlin, Kelly Gambino-Shirley, Eugene Pizzo, Quyen Phan, Alexandra Mercante, Patrick McCormack, Haley Martin, Anna J. Blackstock, Samantha M. Olson, Alycia McNutt, Jocelyn Mullins, Laura Whitlock, Kimberly Holmes-Talbot, Megin Nichols, Wayne Kasacek, Diane Noel, and Laurn Mank
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medicine.medical_specialty ,Veterinary medicine ,E. coli–Escherichia coli ,animal diseases ,diarrhea ,Biology ,Serology ,fluids and secretions ,Hand sanitizer ,children ,SF600-1100 ,medicine ,Feces ,Original Research ,outbreak ,General Veterinary ,Public health ,goat ,Shiga toxin (Stx) producing Escherichia coli (STEC) ,agritourism ,Outbreak ,Diarrhea ,hemolytic uremic syndrome ,Hay ,Veterinary Science ,medicine.symptom ,Barn (unit) - Abstract
The objective of this study was to determine sources of Shiga toxin-producing Escherichia coli O157 (STEC O157) infection among visitors to Farm X and develop public health recommendations. A case-control study was conducted. Case-patients were defined as the first ill child (aged ; of these, 62% (18 of 29) yielded STEC O157 highly related by WGS to patient isolates. STEC O157 environmental contamination and fecal shedding by goats at Farm X was extensive. Farms should provide handwashing stations with soap, running water, and disposable towels. Access to animal areas, including animal pens and enclosures, should be limited for young children who are at risk for severe outcomes from STEC O157 infection. National recommendations should be adopted to reduce disease transmission.
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- 2021
6. An Overview of PulseNet USA Databases
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Beth Tolar, Efrain M. Ribot, Kelley Hise, Steven Stroika, Morgan N Schroeder, Peter Gerner-Smidt, and Lavin A. Joseph
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medicine.medical_specialty ,Databases, Factual ,040301 veterinary sciences ,Applied Microbiology and Biotechnology ,Microbiology ,Disease Outbreaks ,Foodborne Diseases ,0403 veterinary science ,03 medical and health sciences ,medicine ,Humans ,Public Health Surveillance ,Whole genome sequencing ,0303 health sciences ,Whole Genome Sequencing ,030306 microbiology ,Public health ,Review/Overview Articles ,Pulsenet ,04 agricultural and veterinary sciences ,Data science ,United States ,Electrophoresis, Gel, Pulsed-Field ,Databases as Topic ,Animal Science and Zoology ,Public Health ,Business ,Laboratories ,Food Science - Abstract
PulseNet USA is the molecular surveillance network for foodborne disease in the United States. The network consists of state and local public health laboratories, as well as food regulatory agencies, that follow PulseNet's standardized protocols to perform pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS) and analyze the results using standardized software. The raw sequences are uploaded to the GenomeTrakr or PulseNet bioprojects at the National Center for Biotechnology Information. The PFGE patterns and analyzed sequence data are uploaded in real time with associated demographic data to the PulseNet national databases managed at the Centers for Disease Control and Prevention. The PulseNet databases are organism specific and provide a central storage location for molecular and demographic data related to an isolate. Sequences are compared in the databases, thereby facilitating the rapid detection of clusters of foodborne diseases that may represent widespread outbreaks. WGS genotyping data, for example, antibiotic resistance and virulence profiles, are also uploaded in real time to the PulseNet databases to improve food safety surveillance activities.
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- 2019
7. Shiga Toxin–Producing E. coli Infections Associated with Flour
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Jessica Rosner, Lisa A. Newberry, Lyndsay Bottichio, June Wetherington, Stelios Viazis, Jennifer Beal, Jolianne Stone, Morgan N Schroeder, Katherine D. Arends, Beth Melius, Nereida Corral, Darlene Wagner, Samuel J. Crowe, Lauren N. Shade, Krisandra J Allen, Matthew E. Wise, Brooke M. Whitney, Anna J. Blackstock, Eija Trees, Laura Whitlock, Danielle Donovan, and Karen P. Neil
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Adult ,Male ,0301 basic medicine ,Veterinary medicine ,Adolescent ,Flour ,030106 microbiology ,Serogroup ,medicine.disease_cause ,Article ,Disease Outbreaks ,Foodborne Diseases ,Young Adult ,03 medical and health sciences ,Common point ,0404 agricultural biotechnology ,Surveys and Questionnaires ,medicine ,Humans ,Food microbiology ,Child ,Escherichia coli ,Escherichia coli Infections ,Aged ,Aged, 80 and over ,Shiga-Toxigenic Escherichia coli ,business.industry ,Infant ,Outbreak ,04 agricultural and veterinary sciences ,General Medicine ,Odds ratio ,Middle Aged ,040401 food science ,Virology ,United States ,Confidence interval ,Logistic Models ,Shiga toxin producing ,Child, Preschool ,Food Microbiology ,Female ,business - Abstract
In 2016, a multijurisdictional team investigated an outbreak of Shiga toxin-producing Escherichia coli (STEC) serogroup O121 and O26 infections linked to contaminated flour from a large domestic producer.A case was defined as infection with an outbreak strain in which illness onset was between December 21, 2015, and September 5, 2016. To identify exposures associated with the outbreak, outbreak cases were compared with non-STEC enteric illness cases, matched according to age group, sex, and state of residence. Products suspected to be related to the outbreak were collected for STEC testing, and a common point of contamination was sought. Whole-genome sequencing was performed on isolates from clinical and food samples.A total of 56 cases were identified in 24 states. Univariable exact conditional logistic-regression models of 22 matched sets showed that infection was significantly associated with the use of one brand of flour (odds ratio, 21.04; 95% confidence interval [CI], 4.69 to 94.37) and with tasting unbaked homemade dough or batter (odds ratio, 36.02; 95% CI, 4.63 to 280.17). Laboratory testing isolated the outbreak strains from flour samples, and whole-genome sequencing revealed that the isolates from clinical and food samples were closely related to one another genetically. Trace-back investigation identified a common flour-production facility.This investigation implicated raw flour as the source of an outbreak of STEC infections. Although it is a low-moisture food, raw flour can be a vehicle for foodborne pathogens.
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- 2017
8. Notes from the Field: Multistate Outbreak of Escherichia coli O26 Infections Linked to Raw Flour — United States, 2019
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Katherine Purcell, Michael Vasser, Colin Basler, Jonathan Barkley, Ellen Gee, Karen P. Neil, Adam Miller, and Morgan N Schroeder
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Adult ,Male ,Veterinary medicine ,Health (social science) ,Adolescent ,Epidemiology ,Health, Toxicology and Mutagenesis ,Flour ,medicine.disease_cause ,Disease Outbreaks ,Foodborne Diseases ,Young Adult ,Health Information Management ,Raw Foods ,medicine ,Humans ,Food microbiology ,Child ,Escherichia coli ,Escherichia coli Infections ,Aged ,Aged, 80 and over ,Shiga-Toxigenic Escherichia coli ,business.industry ,Outbreak ,General Medicine ,Middle Aged ,United States ,Food Microbiology ,Female ,business ,Notes from the Field - Published
- 2021
9. 130. increase in Multidrug Resistance (2011–2018) and the Emergence of Extensive Drug Resistance (2020) in shigella Sonnei in the United States
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Jenny Draper, Morgan N Schroeder, Naeemah Logan, Beth E. Karp, Elena Martinez, Andrew Ginn, Louise Francois Watkins, Amanda G. Garcia-Williams, Ian D Plumb, Kevin O’Laughlin, Hattie E. Webb, Eby Sim, Claire Burns-Lynch, Jonathan R. Iredell, Kaitlin A. Tagg, Hannah Zenas, Jessica C. Chen, Sally R. Partridge, Zachary A Marsh, and Vitali Sintchenko
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Multiple drug resistance ,AcademicSubjects/MED00290 ,Infectious Diseases ,Oncology ,business.industry ,Poster Abstracts ,Medicine ,Shigella sonnei ,business ,EXTENSIVE DRUG RESISTANCE ,Microbiology - Abstract
Background Multidrug-resistant (MDR) Shigella sonnei infections are a serious public health threat, and outbreaks are common among men who have sex with men (MSM). In February 2020, Australia’s Department of Health notified CDC of extensively drug-resistant (XDR) S. sonnei in 2 Australian residents linked to a cruise that departed from Florida. We describe an international outbreak of XDR S. sonnei and report on trends in MDR among S. sonnei in the United States. Methods Health departments (HDs) submit every 20th Shigella isolate to CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory for susceptibility testing. We defined MDR as decreased susceptibility to azithromycin (MIC ≥32 µg/mL) with resistance to ampicillin, ciprofloxacin, and cotrimoxazole, and XDR as MDR with additional resistance to ceftriaxone. We used PulseNet, the national subtyping network for enteric disease surveillance, to identify US isolates related to the Australian XDR isolates by short-read whole genome sequencing. We screened these isolates for resistance determinants (ResFinder v3.0) and plasmid replicons (PlasmidFinder) and obtained patient histories from HDs. We used long-read sequencing to generate closed plasmid sequences for 2 XDR isolates. Results NARMS tested 2,781 S. sonnei surveillance isolates during 2011–2018; 80 (2.9%) were MDR, including 1 (0.04%) that was XDR. MDR isolates were from men (87%), women (9%), and children (4%). MDR increased from 0% in 2011 to 15.3% in 2018 (Figure). In 2020, we identified XDR isolates from 3 US residents on the same cruise as the Australians. The US residents were 41–42 year-old men; 2 with available information were MSM. The US and Australian isolates were highly related (0–1 alleles). Short-read sequence data from all 3 US isolates mapped to the blaCTX-M-27 harboring IncFII plasmids from the 2 Australian isolates with >99% nucleotide identity. blaCTX-M-27 genes confer ceftriaxone resistance. Increase in Percentage of Shigella sonnei Isolates with Multidrug Resistance* in the United States, 2011–2018† Conclusion MDR S. sonnei is increasing and is most often identified among men. XDR S. sonnei infections are emerging and are resistant to all recommended antibiotics, making them difficult to treat without IV antibiotics. This outbreak illustrates the alarming capacity for XDR S. sonnei to disseminate globally among at-risk populations, such as MSM. Disclosures All Authors: No reported disclosures
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- 2020
10. Outbreak of E. coli O157:H7 Infections Associated with Exposure to Animal Manure in a Rural Community - Arizona and Utah, June-July 2017
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Allyn Nakashima, Sarah Luna, Melanie Sarino, Roumen Penev, Jennifer Wagner, Melissa Dimond, Deidre Barlow, Mackenzie Tewell, Louise Saw, Laura Gieraltowski, Laine McCullough, Jeffrey Eason, Jenna Weigand, Morgan N Schroeder, Matthew E. Wise, Colin Basler, Anna Scherzer, Cindy Burnett, Vikram Krishnasamy, Marilee Kellis, Kelly F. Oakeson, Keegan McCaffrey, Rashida Hassan, and Lori Smith
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0301 basic medicine ,Adult ,Male ,Rural Population ,medicine.medical_specialty ,Health (social science) ,Adolescent ,Epidemiology ,Health, Toxicology and Mutagenesis ,media_common.quotation_subject ,030106 microbiology ,Escherichia coli O157 ,Disease Outbreaks ,03 medical and health sciences ,Young Adult ,Health Information Management ,Hygiene ,Environmental health ,Utah ,Medicine ,Animals ,Humans ,Horses ,Full Report ,Child ,Escherichia coli Infections ,media_common ,Rural community ,Shiga-Toxigenic Escherichia coli ,business.industry ,Transmission (medicine) ,Arizona ,Outbreak ,Infant ,General Medicine ,Environmental Exposure ,Manure ,030104 developmental biology ,Child, Preschool ,Cattle ,Female ,Rural area ,business ,Contact tracing - Abstract
On June 26, 2017, a hospital in southern Utah notified the Utah Department of Health of Shiga toxin-producing Escherichia coli (STEC) O157:H7 infections in two children from a small community on the Arizona-Utah border. Both children developed hemolytic uremic syndrome, characterized by hemolytic anemia, acute kidney failure, and thrombocytopenia and died within a few days of illness onset. Over the next few days, several more STEC-associated illnesses were reported in residents of the community. A joint investigation by local and state health agencies from Arizona and Utah and CDC was initiated to identify the outbreak source and prevent additional cases; a total of 12 cases were identified, including the two children who died. Investigators initially explored multiple potential sources of illness; epidemiologic and environmental information revealed cow manure contact as the likely initial cause of the outbreak, which was followed by subsequent person-to-person transmission. One of the outbreak strains was isolated from bull and horse manure collected from a yard near a community household with two ill children. Local health agencies made recommendations to the public related to both animal contact and hand hygiene to reduce the risk for STEC transmission. Animal or animal manure contact should be considered a potential source of STEC O157:H7 during outbreaks in communities where ruminants are kept near the home.
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- 2018
11. Laboratory Investigation of Salmonella enterica serovar Poona Outbreak in California: Comparison of Pulsed-Field Gel Electrophoresis (PFGE) and Whole Genome Sequencing (WGS) Results
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Darlene Wagner, Eija Trees, Ashley Sabol, John Crandall, Jeniffer Concepción-Acevedo, Jeffrey Higa, Varvara K. Kozyreva, Vishnu Chaturvedi, Peng Zhang, Morgan N Schroeder, and Alyssa Poe
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0301 basic medicine ,Serotype ,Whole genome sequencing ,Salmonella ,biology ,phylogenetic analysis ,Medicine (miscellaneous) ,Outbreak ,biology.organism_classification ,medicine.disease_cause ,Microbiology ,03 medical and health sciences ,030104 developmental biology ,pulsed-field gel electrophoresis ,whole-genome sequencing ,Salmonella enterica ,Pulsed-field gel electrophoresis ,medicine ,Multilocus sequence typing ,Salmonella serovar Poona ,Genotyping ,Research Article - Abstract
Introduction: Recently, Salmonella enterica serovar Poona caused a multistate outbreak, with 245 out of 907 cases occurring in California. We report a comparison of pulsed-field gel electrophoresis (PFGE) results with whole genome sequencing (WGS) for genotyping of Salmonella Poona isolates. Methods: CA Salmonella Poona isolates, collected from July to August 2015, were genotyped by PFGE using XbaI restriction enzyme. WGS was done using Nextera XT library kit with 2x300 bp or 2x250 bp sequencing chemistry on the Illumina MiSeq Sequencer. Reads were mapped to the de novo assembled serovar Poona draft genome (48 contigs, N50= 223,917) from the outbreak using CLCbio GW 8.0.2. The phylogenetic tree was generated based on hqSNPs calling. Genomes were annotated with CGE and PHAST online tools. In silico MLST was performed using the CGE online tool. Results: Human (14) and cucumber (2) Salmonella Poona isolates exhibited 3 possibly related PFGE patterns (JL6X01.0018 [predominant], JL6X01.0375, JL6X01.0778). All isolates that were related by PFGE also clustered together according to the WGS. One isolate with a divergent PFGE pattern (JL6X01.0776) served as an outlier in the phylogenetic analysis and substantially differed from the outbreak clade by WGS. All outbreak isolates were assigned to MLST sequence type 447. The majority of the outbreak-related isolates possessed the same set of Salmonella Pathogenicity Islands with few variations. One outbreak isolate was sequenced and analyzed independently by CDC and CDPH laboratories; there was 0 SNP difference in results. Additional two isolates were sequenced by CDC and the raw data was processed through CDPH and CDC analysis pipelines. Both data analysis pipelines also generated concordant results. Discussion: PFGE and WGS results for the recent CA Salmonella enterica serovar Poona outbreak provided concordant assignment of the isolates to the outbreak cluster. WGS allowed more robust determination of genetic relatedness, provided information regarding MLST-type, pathogenicity genes, and bacteriophage content. WGS data obtained independently at two laboratories showed complete agreement.
- Published
- 2016
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