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Investigation of a Lomentospora prolificans case cluster with whole genome sequencing

Peter Boan1,2, Stanley Pang3, Dianne J Gardam2

  • 1Fiona Stanley Hospital, 11 Robin Warren Ave, Murdoch, Perth, 6150, Australia.

Medical Mycology Case Reports
|June 2, 2020
PubMed

Insights

Whole genome sequencing revealed significant genetic diversity among Lomentospora prolificans isolates from hospital infections. This finding suggests multiple introductions rather than a single source strain causing the outbreaks in immunocompromised patients.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Genomics

Background:

  • Lomentospora prolificans is an emerging fungal pathogen causing severe infections, particularly in immunocompromised individuals.
  • Outbreaks of L. prolificans have been reported in hospital settings, raising concerns about transmission and source identification.

Purpose of the Study:

  • To investigate the genetic relatedness of Lomentospora prolificans isolates from distinct hospital-acquired infections.
  • To determine if a single strain was responsible for L. prolificans outbreaks in a hematology unit.

Main Methods:

  • Whole genome sequencing (WGS) was performed on six L. prolificans isolates.
  • Isolates were obtained from infections occurring over an eight-month period in a hospital hematology unit and from unrelated infections at another hospital.

Main Results:

  • Significant genetic diversity was observed between L. prolificans isolates, with over 10,000 single nucleotide polymorphisms (SNPs) differentiating isolates from the same hospital.
  • WGS-based typing did not identify a single common causative strain for the observed infections.

Conclusions:

  • The genetic variability among L. prolificans isolates suggests multiple independent introductions into the hospital environment.
  • The findings challenge the notion of a single source strain in hospital outbreaks and highlight the need for comprehensive infection control strategies.
Keywords:
Antifungal resistanceFungal outbreakLomentospora prolificansScedosporium prolificansWhole genome sequencing

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