title: Whole genome sequence typing to investigate the Apophysomyces outbreak following a tornado in Joplin, Missouri, 2011.
abstract: Case reports of Apophysomyces spp. in immunocompetent hosts have been a result of traumatic deep implantation of Apophysomyces spp. spore-contaminated soil or debris. On May 22, 2011 a tornado occurred in Joplin, MO, leaving 13 tornado victims with Apophysomyces trapeziformis infections as a result of lacerations from airborne material. We used whole genome sequence typing (WGST) for high-resolution phylogenetic SNP analysis of 17 outbreak Apophysomyces isolates and five additional temporally and spatially diverse Apophysomyces control isolates (three A. trapeziformis and two A. variabilis isolates). Whole genome SNP phylogenetic analysis revealed three clusters of genotypically related or identical A. trapeziformis isolates and multiple distinct isolates among the Joplin group; this indicated multiple genotypes from a single or multiple sources. Though no linkage between genotype and location of exposure was observed, WGST analysis determined that the Joplin isolates were more closely related to each other than to the control isolates, suggesting local population structure. Additionally, species delineation based on WGST demonstrated the need to reassess currently accepted taxonomic classifications of phylogenetic species within the genus Apophysomyces.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA. ketienne@cdc.gov
authors.forename: Kizee A
authors.initials: KA
authors.lastname: Etienne
authors.forename: John
authors.initials: J
authors.lastname: Gillece
authors.forename: Remy
authors.initials: R
authors.lastname: Hilsabeck
authors.forename: Jim M
authors.initials: JM
authors.lastname: Schupp
authors.forename: Rebecca
authors.initials: R
authors.lastname: Colman
authors.forename: Shawn R
authors.initials: SR
authors.lastname: Lockhart
authors.forename: Lalitha
authors.initials: L
authors.lastname: Gade
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Thompson
authors.forename: Deanna A
authors.initials: DA
authors.lastname: Sutton
authors.forename: Robyn
authors.initials: R
authors.lastname: Neblett-Fanfair
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Park
authors.forename: George
authors.initials: G
authors.lastname: Turabelidze
authors.forename: Paul
authors.initials: P
authors.lastname: Keim
authors.forename: Mary E
authors.initials: ME
authors.lastname: Brandt
authors.forename: Eszter
authors.initials: E
authors.lastname: Deak
authors.forename: David M
authors.initials: DM
authors.lastname: Engelthaler
mesh_terms: D004190:Disasters; D004196:Disease Outbreaks; D016680:Genome, Bacterial; D006801:Humans; D008923:Missouri; D009090:Mucorales / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D009091:Mucormycosis / Q000453:epidemiology / Q000382:microbiology*; D010802:Phylogeny; D020641:Polymorphism, Single Nucleotide; D017422:Sequence Analysis, DNA; D055869:Tornadoes