title: Whole-Genome Sequencing to Determine Origin of Multinational Outbreak of Sarocladium kiliense Bloodstream Infections.
abstract: We used whole-genome sequence typing (WGST) to investigate an outbreak of Sarocladium kiliense bloodstream infections (BSI) associated with receipt of contaminated antinausea medication among oncology patients in Colombia and Chile during 2013-2014. Twenty-five outbreak isolates (18 from patients and 7 from medication vials) and 11 control isolates unrelated to this outbreak were subjected to WGST to elucidate a source of infection. All outbreak isolates were nearly indistinguishable (<5 single-nucleotide polymorphisms), and >21,000 single-nucleotide polymorphisms were identified from unrelated control isolates, suggesting a point source for this outbreak. S. kiliense has been previously implicated in healthcare-related infections; however, the lack of available typing methods has precluded the ability to substantiate point sources. WGST for outbreak investigation caused by eukaryotic pathogens without reference genomes or existing genotyping methods enables accurate source identification to guide implementation of appropriate control and prevention measures.
authors.forename: Kizee A
authors.initials: KA
authors.lastname: Etienne
authors.forename: Chandler C
authors.initials: CC
authors.lastname: Roe
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Smith
authors.forename: Snigdha
authors.initials: S
authors.lastname: Vallabhaneni
authors.forename: Carolina
authors.initials: C
authors.lastname: Duarte
authors.forename: Patricia
authors.initials: P
authors.lastname: Escadon
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Castaneda
authors.forename: Beatriz L
authors.initials: BL
authors.lastname: Gomez
authors.forename: Catalina
authors.initials: C
authors.lastname: de Bedout
authors.forename: Luisa F
authors.initials: LF
authors.lastname: López
authors.forename: Valentina
authors.initials: V
authors.lastname: Salas
authors.forename: Luz Maria
authors.initials: LM
authors.lastname: Hederra
authors.forename: Jorge
authors.initials: J
authors.lastname: Fernandez
authors.forename: Paola
authors.initials: P
authors.lastname: Pidal
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Hormazabel
authors.forename: Fernando
authors.initials: F
authors.lastname: Otaiza
authors.forename: Fredrik O
authors.initials: FO
authors.lastname: Vannberg
authors.forename: John
authors.initials: J
authors.lastname: Gillece
authors.forename: Darrin
authors.initials: D
authors.lastname: Lemmer
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Driebe
authors.forename: David M
authors.initials: DM
authors.lastname: Englethaler
authors.forename: Anastasia P
authors.initials: AP
authors.lastname: Litvintseva
mesh_terms: D000932:Antiemetics / Q000009:adverse effects*; D002677:Chile; D003105:Colombia; D004271:DNA, Fungal; D004196:Disease Outbreaks; D004340:Drug Contamination; D016469:Fungemia / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D006999:Hypocreales / Q000235:genetics / Q000302:isolation & purification; D020641:Polymorphism, Single Nucleotide; D017422:Sequence Analysis, DNA
chemical_list: D000932:Antiemetics; D004271:DNA, Fungal
keywords: Chile; Colombia; Latin America; bloodstream infections; epidemiology; fungal outbreaks; fungi; whole-genome sequencing