title: Clusters of genetically similar isolates of Pseudomonas aeruginosa from multiple hospitals in the UK.
abstract: Variable number tandem repeat (VNTR) analysis at nine loci of isolates of Pseudomonas aeruginosa submitted to the national reference laboratory from UK hospitals, from over 2000 patients, between June 2010 and June 2012 revealed four widely found types that collectively were received from approximately a fifth of patients, including from those with cystic fibrosis. These types were also prevalent among related submissions from the clinical environment and were received from up to 54 (out of 143) hospitals. Multi-locus sequence typing and blaOXA-50-like sequencing confirmed the clonal relationship within each cluster, and representatives from multiple centres clustered within about 70 % by pulsed-field gel electrophoresis. Illumina sequencing of 12 isolates of cluster A of VNTR profile 8, 3, 4, 5, 2, 3, 5, 2, x (where the repeat number at the last, most discriminatory locus is variable) revealed a large number of variably present targets in the accessory genome and seven of these were sought by PCR among a larger set of isolates. Representatives from patients within a single centre mostly had distinct accessory gene profiles, suggesting that these patients acquired the strain independently, while those with clear epidemiological links shared the same profile. Profiles also varied between representatives from different centres. Epidemiological investigations of widely found types such as these require the use of finer-typing methods, which increasingly will be informed by next generation sequencing.
authors.affiliation: Antimicrobial Resistance and Healthcare Associated Infections, Microbiology Services - Colindale, Public Health England, London NW9 5EQ, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Martin
authors.affiliation: Antimicrobial Resistance and Healthcare Associated Infections, Microbiology Services - Colindale, Public Health England, London NW9 5EQ, UK.
authors.forename: Buket
authors.initials: B
authors.lastname: Baddal
authors.affiliation: Antimicrobial Resistance and Healthcare Associated Infections, Microbiology Services - Colindale, Public Health England, London NW9 5EQ, UK.
authors.forename: Nazim
authors.initials: N
authors.lastname: Mustafa
authors.affiliation: Antimicrobial Resistance and Healthcare Associated Infections, Microbiology Services - Colindale, Public Health England, London NW9 5EQ, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Perry
authors.affiliation: Bioinformatics Group, Applied Laboratory and Bio-Informatics Unit, Microbiology Services - Colindale, Public Health England, London NW9 5EQ, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: Underwood
authors.affiliation: School of Biosciences, University of Birmingham, Birmingham B15 2TT, UK.
authors.forename: Chrystala
authors.initials: C
authors.lastname: Constantidou
authors.affiliation: School of Biosciences, University of Birmingham, Birmingham B15 2TT, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Loman
authors.affiliation: Antimicrobial Resistance and Healthcare Associated Infections, Microbiology Services - Colindale, Public Health England, London NW9 5EQ, UK.
authors.forename: Dervla T
authors.initials: DT
authors.lastname: Kenna
authors.affiliation: Antimicrobial Resistance and Healthcare Associated Infections, Microbiology Services - Colindale, Public Health England, London NW9 5EQ, UK.
authors.forename: Jane F
authors.initials: JF
authors.lastname: Turton
mesh_terms: D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D015964:Gene Expression Regulation, Bacterial / Q000502:physiology; D006761:Hospitals; D006801:Humans; D018598:Minisatellite Repeats; D008969:Molecular Sequence Data; D010802:Phylogeny; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000145:classification* / Q000235:genetics* / Q000502:physiology; D006113:United Kingdom / Q000453:epidemiology