Legionnaires’ Disease Outbreak Caused by Endemic Strain of <i>Legionella pneumophila</i>, New York, New York, USA, 2015

Lapierre, Pascal; Nazarian, Elizabeth; Zhu, Yan; Wroblewski, Danielle; Saylors, Amy; Passaretti, Teresa; Hughes, Scott; Tran, Anthony; Lin, Ying; Kornblum, John; Morrison, Shatavia S.; Mercante, Jeffrey W.; Fitzhenry, Robert; Weiss, Don; Raphael, Brian; Varma, Jay K.; Zucker, Howard A.; Rakeman, Jennifer L.; Musser, Kimberlee A.

doi:10.3201/eid2311.170308

Cited by 40 publications

(40 citation statements)

References 37 publications

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“…Pockets of genetic clustering among geographically related isolates without confirmed epidemiological association have been recently described [ 48 ] and were also noted here in clades from the US Southeast (‘C45-S’, ‘C101-P’, ‘C65-P’, ‘C84-P’, ‘E68-N’, and ‘C116-P’), South Dakota (‘C64-S’, ‘C23-S’, ‘C40-S’, ‘C17-S’, ‘C19-S’, and ‘C79-S’), and Sweden (‘EUL00108’, ‘LP21’, ‘EUL00109’, ‘LP23’, and ‘EUL00104’). Therefore, we investigated genetic differentiation among geographic populations through an analysis of molecular variance (AMOVA) [ 49 ].…”

Section: Resultsmentioning

confidence: 99%

Genomic heterogeneity differentiates clinical and environmental subgroups of Legionella pneumophila sequence type 1

et al. 2018

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Legionella spp. are the cause of a severe bacterial pneumonia known as Legionnaires’ disease (LD). In some cases, current genetic subtyping methods cannot resolve LD outbreaks caused by common, potentially endemic L. pneumophila (Lp) sequence types (ST), which complicates laboratory investigations and environmental source attribution. In the United States (US), ST1 is the most prevalent clinical and environmental Lp sequence type. In order to characterize the ST1 population, we sequenced 289 outbreak and non-outbreak associated clinical and environmental ST1 and ST1-variant Lp strains from the US and, together with international isolate sequences, explored their genetic and geographic diversity. The ST1 population was highly conserved at the nucleotide level; 98% of core nucleotide positions were invariant and environmental isolates unassociated with human disease (n = 99) contained ~65% more nucleotide diversity compared to clinical-sporadic (n = 139) or outbreak-associated (n = 28) ST1 subgroups. The accessory pangenome of environmental isolates was also ~30–60% larger than other subgroups and was enriched for transposition and conjugative transfer-associated elements. Up to ~10% of US ST1 genetic variation could be explained by geographic origin, but considerable genetic conservation existed among strains isolated from geographically distant states and from different decades. These findings provide new insight into the ST1 population structure and establish a foundation for interpreting genetic relationships among ST1 strains; these data may also inform future analyses for improved outbreak investigations.

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Section: Resultsmentioning

confidence: 99%

Genomic heterogeneity differentiates clinical and environmental subgroups of Legionella pneumophila sequence type 1

et al. 2018

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“…Several prominent outbreaks have increased attention on LD in the United States recently. 2 , 3 , 4 , 5 , 6 Legionellosis (including LD and the milder Pontiac fever) is reportable to the Centers for Disease Control and Prevention (CDC); 6079 cases were reported in 2015. 7 Rates of reported legionellosis have been increasing for decades.…”

Section: Introductionmentioning

confidence: 99%

Legionnaires Disease Surveillance in US Department of Veterans Affairs Medical Facilities and Assessment of Health Care Facility Association

et al. 2018

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Key Points Question What is the Legionnaires disease burden in the US Department of Veterans Affairs medical facilities, a health care system that has prioritized Legionnaires disease prevention with policy? Findings In this cohort study, the number of Legionnaires disease cases was low (n = 491) and 91% of cases had no VA exposure or only outpatient VA exposure. Total rates of Legionnaires disease significantly increased from 2014 to 2016, but rates in cases with overnight health care system exposure significantly decreased. Meaning Although total Legionnaires disease rates increased, health care system–associated (overnight stay) rates decreased significantly, suggesting that prevention efforts may have contributed to improved patient safety in these settings.

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“…The main added value of implementing WGS during surveillance activities or outbreak investigations is inherent in the higher resolution of the WGS output itself, leading to an increased sensitivity and specificity to identify transmission clusters compared to conventional subtyping methods [6]. As such, there are numerous success stories of outbreak investigations applying WGS that were able to identify to the source of infection and implement targeted control measures to stop further spread, saving resources at the health protection and local authority level [10][11][12][13][14][15][16][17]. Other concrete examples of the utility of WGS for national surveillance and local infection control include the guidance of vaccination strategies [18][19][20][21] and antibiotic stewardship [22,23].…”

Section: Introductionmentioning

confidence: 99%

Perceived utility and feasibility of pathogen genomics for public health practice: a survey among public health professionals working in the field of infectious diseases, Belgium, 2019

et al. 2020

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Background: Pathogen genomics is increasingly being translated from the research setting into the activities of public health professionals operating at different levels. This survey aims to appraise the literacy level and gather the opinions of public health experts and allied professionals working in the field of infectious diseases in Belgium concerning the implementation of next-generation sequencing (NGS) in public health practice. Methods: In May 2019, Belgian public health and healthcare professionals were invited to complete an online survey containing eight main topics including background questions, general attitude towards pathogen genomics for public health practice and main concerns, genomic literacy, current and planned NGS activities, place of NGS in diagnostic microbiology pathways, data sharing obstacles, end-user requirements, and key drivers for the implementation of NGS. Descriptive statistics were used to report on the frequency distribution of multiple choice responses whereas thematic analysis was used to analyze free text responses. A multivariable logistic regression model was constructed to identify important predictors for a positive attitude towards the implementation of pathogen genomics in public health practice.

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Legionnaires’ Disease Outbreak Caused by Endemic Strain of Legionella pneumophila, New York, New York, USA, 2015

Cited by 40 publications

References 37 publications

Genomic heterogeneity differentiates clinical and environmental subgroups of Legionella pneumophila sequence type 1

Genomic heterogeneity differentiates clinical and environmental subgroups of Legionella pneumophila sequence type 1

Legionnaires Disease Surveillance in US Department of Veterans Affairs Medical Facilities and Assessment of Health Care Facility Association

Perceived utility and feasibility of pathogen genomics for public health practice: a survey among public health professionals working in the field of infectious diseases, Belgium, 2019

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