b Salmonella enterica serovar Enteritidis is a significant cause of gastrointestinal illness in the United States; however, current molecular subtyping methods lack resolution for this highly clonal serovar. Advances in next-generation sequencing technologies have made it possible to examine whole-genome sequencing (WGS) as a potential molecular subtyping tool for outbreak detection and source trace back. Here, we conducted a retrospective analysis of S. Enteritidis isolates from seven epidemiologically confirmed foodborne outbreaks and sporadic isolates (not epidemiologically linked) to determine the utility of WGS to identify outbreaks. A collection of 55 epidemiologically characterized clinical and environmental S. Enteritidis isolates were sequenced. Single nucleotide polymorphism (SNP)-based cluster analysis of the S. Enteritidis genomes revealed well supported clades, with less than four-SNP pairwise diversity, that were concordant with epidemiologically defined outbreaks. Sporadic isolates were an average of 42.5 SNPs distant from the outbreak clusters. Isolates collected from the same patient over several weeks differed by only two SNPs. Our findings show that WGS provided greater resolution between outbreak, sporadic, and suspect isolates than the current gold standard subtyping method, pulsed-field gel electrophoresis (PFGE). Furthermore, results could be obtained in a time frame suitable for surveillance activities, supporting the use of WGS as an outbreak detection and characterization method for S. Enteritidis.
Foodborne bacterial pathogen characterization, surveillance, and outbreak detection is an important function of the public health laboratory (1). Current practices involve time-and laborintensive phenotypic typing, including biochemical profiling, phage typing, serotyping, and antimicrobial susceptibility testing. In addition, a variety of species-specific molecular methods for advanced characterization are utilized, including pulsed-field gel electrophoresis (PFGE), multiple-locus variable number tandem repeat analysis (MLVA), and virulence gene typing (2). Often, it is necessary to combine results from multiple techniques to provide an adequate level of discrimination in order to identify outbreak clusters within routine clinical surveillance isolates.Salmonella is an important foodborne pathogen that is estimated to be responsible for approximately 1 million cases of illness and more than 450 deaths annually in the United States (3). Salmonella enterica serovar Enteritidis is responsible for 36% of Salmonella outbreaks in the United States, and in 1990, it replaced Salmonella enterica serovar Typhimurium as the most frequently reported serotype of Salmonella worldwide (4, 5). It is estimated that approximately 64% of S. Enteritidis clinical cases are attributable to contaminated eggs and 18% to poultry products (5, 6).There is limited genetic variation between the strains of S. Enteritidis, which reduces the utility of current subtyping methods (7-9). For example, PFGE, the gold standard s...