Whole Genome Sequencing in Real-Time Investigation and Management of a XXXX Outbreak on a Neonatal Intensive Care Unit.

@entity1 @entity281 @entity796
UNASSIGNED: OBJECTIVE To use whole genome sequencing to describe the likely origin of an outbreak of @entity796 in a neonatal unit. DESIGN Outbreak investigation. SETTING The neonatal intensive care unit service of a major obstetric tertiary referral center. @entity1 @entity1 admitted to the neonatal unit who developed @entity796 colonization or @entity281 . METHODS We undertook whole genome sequencing of @entity796 strains isolated from colonized @entity1 and from the neonatal unit environment. RESULTS Eighteen @entity1 were colonized with @entity796 . Isolates from 12 @entity1 and 7 environmental samples were sequenced. All but one of the clinical isolates clustered in ST253 and no differences were detected between unmapped reads. The environmental isolates revealed a variety of sequence types, indicating a large diverse bioburden within the unit, which was subsequently confirmed via enterobacterial repetitive intergenic consensus         polymerase chain reaction typing of post-outbreak isolates. One environmental isolate, obtained from a sink in the unit, clustered within ST253 and differed from the outbreak strain by 9 single-nucleotide polymorphisms only. This information allowed us to focus @entity281 control activities on this sink. CONCLUSIONS Whole genome sequencing can provide detailed information in a clinically relevant time frame to aid management of outbreaks in critical @entity1 management areas. The superior discriminatory power of this method makes it a powerful tool in @entity281 control. Infect Control Hosp Epidemiol 2015;00(0):1         7.
