Culture of Clinical Specimens Reveals Extensive Diversity of <named-content content-type="genus-species">Legionella pneumophila</named-content> Strains in Arizona
ABSTRACT Between 2000 and 2017, a total of 236 Legionella species isolates from Arizona were submitted to the CDC for reference testing. Most of these isolates were recovered from bronchoalveolar lavage specimens. Although the incidence of legionellosis in Arizona is less than the overall U.S. incid...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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American Society for Microbiology
2019-02-01
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| Series: | mSphere |
| Subjects: | |
| Online Access: | https://journals.asm.org/doi/10.1128/mSphere.00649-18 |
| _version_ | 1818927176867643392 |
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| author | Brian H. Raphael Trung Huynh Ellen Brown Jessica C. Smith Irene Ruberto Linda Getsinger Stacy White Jonas M. Winchell |
| author_facet | Brian H. Raphael Trung Huynh Ellen Brown Jessica C. Smith Irene Ruberto Linda Getsinger Stacy White Jonas M. Winchell |
| author_sort | Brian H. Raphael |
| collection | DOAJ |
| description | ABSTRACT Between 2000 and 2017, a total of 236 Legionella species isolates from Arizona were submitted to the CDC for reference testing. Most of these isolates were recovered from bronchoalveolar lavage specimens. Although the incidence of legionellosis in Arizona is less than the overall U.S. incidence, Arizona submits the largest number of isolates to the CDC for testing compared to those from other states. In addition to a higher proportion of culture confirmation of legionellosis cases in Arizona than in other states, all Legionellapneumophila isolates are forwarded to the CDC for confirmatory testing. Compared to that from other states, a higher proportion of isolates from Arizona were identified as belonging to L. pneumophila serogroups 6 (28.2%) and 8 (8.9%). Genome sequencing was conducted on 113 L. pneumophila clinical isolates not known to be associated with outbreaks in order to understand the genomic diversity of strains causing legionellosis in Arizona. Whole-genome multilocus sequence typing (wgMLST) revealed 17 clusters of isolates sharing at least 99% identical allele content. Only two of these clusters contained isolates from more than one individual with exposure at the same facility. Additionally, wgMLST analysis revealed a group of 31 isolates predominantly belonging to serogroup 6 and containing isolates from three separate clusters. Single nucleotide polymorphism (SNP) and pangenome analysis were used to further resolve genome sequences belonging to a subset of isolates. This study demonstrates that culture of clinical specimens for Legionella spp. reveals a highly diverse population of strains causing legionellosis in Arizona which could be underappreciated using other diagnostic approaches. IMPORTANCE Culture of clinical specimens from patients with Legionnaires’ disease is rarely performed, restricting our understanding of the diversity and ecology of Legionella. Culture of Legionella from patient specimens in Arizona revealed a greater proportion of non-serogroup 1 Legionellapneumophila isolates than in other U.S. isolates examined. Disease caused by such isolates may go undetected using other diagnostic methods. Moreover, genome sequence analysis revealed that these isolates were genetically diverse, and understanding these populations may help in future environmental source attribution studies. |
| first_indexed | 2024-12-20T03:08:51Z |
| format | Article |
| id | doaj.art-9adaef9f10574cb794dd197f63f088a5 |
| institution | Directory Open Access Journal |
| issn | 2379-5042 |
| language | English |
| last_indexed | 2024-12-20T03:08:51Z |
| publishDate | 2019-02-01 |
| publisher | American Society for Microbiology |
| record_format | Article |
| series | mSphere |
| spelling | doaj.art-9adaef9f10574cb794dd197f63f088a52022-12-21T19:55:32ZengAmerican Society for MicrobiologymSphere2379-50422019-02-014110.1128/mSphere.00649-18Culture of Clinical Specimens Reveals Extensive Diversity of <named-content content-type="genus-species">Legionella pneumophila</named-content> Strains in ArizonaBrian H. Raphael0Trung Huynh1Ellen Brown2Jessica C. Smith3Irene Ruberto4Linda Getsinger5Stacy White6Jonas M. Winchell7Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USAArizona Department of Health Services, Phoenix, Arizona, USARespiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USARespiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USAArizona Department of Health Services, Phoenix, Arizona, USAArizona Department of Health Services, Phoenix, Arizona, USAArizona Department of Health Services, Phoenix, Arizona, USARespiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USAABSTRACT Between 2000 and 2017, a total of 236 Legionella species isolates from Arizona were submitted to the CDC for reference testing. Most of these isolates were recovered from bronchoalveolar lavage specimens. Although the incidence of legionellosis in Arizona is less than the overall U.S. incidence, Arizona submits the largest number of isolates to the CDC for testing compared to those from other states. In addition to a higher proportion of culture confirmation of legionellosis cases in Arizona than in other states, all Legionellapneumophila isolates are forwarded to the CDC for confirmatory testing. Compared to that from other states, a higher proportion of isolates from Arizona were identified as belonging to L. pneumophila serogroups 6 (28.2%) and 8 (8.9%). Genome sequencing was conducted on 113 L. pneumophila clinical isolates not known to be associated with outbreaks in order to understand the genomic diversity of strains causing legionellosis in Arizona. Whole-genome multilocus sequence typing (wgMLST) revealed 17 clusters of isolates sharing at least 99% identical allele content. Only two of these clusters contained isolates from more than one individual with exposure at the same facility. Additionally, wgMLST analysis revealed a group of 31 isolates predominantly belonging to serogroup 6 and containing isolates from three separate clusters. Single nucleotide polymorphism (SNP) and pangenome analysis were used to further resolve genome sequences belonging to a subset of isolates. This study demonstrates that culture of clinical specimens for Legionella spp. reveals a highly diverse population of strains causing legionellosis in Arizona which could be underappreciated using other diagnostic approaches. IMPORTANCE Culture of clinical specimens from patients with Legionnaires’ disease is rarely performed, restricting our understanding of the diversity and ecology of Legionella. Culture of Legionella from patient specimens in Arizona revealed a greater proportion of non-serogroup 1 Legionellapneumophila isolates than in other U.S. isolates examined. Disease caused by such isolates may go undetected using other diagnostic methods. Moreover, genome sequence analysis revealed that these isolates were genetically diverse, and understanding these populations may help in future environmental source attribution studies.https://journals.asm.org/doi/10.1128/mSphere.00649-18Legionella pneumophilaclinical microbiologygenomic epidemiologypublic healthwhole-genome MLST |
| spellingShingle | Brian H. Raphael Trung Huynh Ellen Brown Jessica C. Smith Irene Ruberto Linda Getsinger Stacy White Jonas M. Winchell Culture of Clinical Specimens Reveals Extensive Diversity of <named-content content-type="genus-species">Legionella pneumophila</named-content> Strains in Arizona mSphere Legionella pneumophila clinical microbiology genomic epidemiology public health whole-genome MLST |
| title | Culture of Clinical Specimens Reveals Extensive Diversity of <named-content content-type="genus-species">Legionella pneumophila</named-content> Strains in Arizona |
| title_full | Culture of Clinical Specimens Reveals Extensive Diversity of <named-content content-type="genus-species">Legionella pneumophila</named-content> Strains in Arizona |
| title_fullStr | Culture of Clinical Specimens Reveals Extensive Diversity of <named-content content-type="genus-species">Legionella pneumophila</named-content> Strains in Arizona |
| title_full_unstemmed | Culture of Clinical Specimens Reveals Extensive Diversity of <named-content content-type="genus-species">Legionella pneumophila</named-content> Strains in Arizona |
| title_short | Culture of Clinical Specimens Reveals Extensive Diversity of <named-content content-type="genus-species">Legionella pneumophila</named-content> Strains in Arizona |
| title_sort | culture of clinical specimens reveals extensive diversity of named content content type genus species legionella pneumophila named content strains in arizona |
| topic | Legionella pneumophila clinical microbiology genomic epidemiology public health whole-genome MLST |
| url | https://journals.asm.org/doi/10.1128/mSphere.00649-18 |
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