Multicenter Outbreak of Infections by <italic toggle="yes">Saprochaete clavata</italic>, an Unrecognized Opportunistic Fungal Pathogen

ABSTRACT Rapidly fatal cases of invasive fungal infections due to a fungus later identified as Saprochaete clavata were reported in France in May 2012. The objectives of this study were to determine the clonal relatedness of the isolates and to investigate possible sources of contamination. A nation...

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Autores principales:	Sophie Vaux, Alexis Criscuolo, Marie Desnos-Ollivier, Laure Diancourt, Chloé Tarnaud, Matthias Vandenbogaert, Sylvain Brisse, Bruno Coignard, Françoise Dromer
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2014
Materias:	Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/4a702ff7c1c74946b00db0de3e523464
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spelling	oai:doaj.org-article:4a702ff7c1c74946b00db0de3e5234642021-11-15T15:47:04ZMulticenter Outbreak of Infections by <italic toggle="yes">Saprochaete clavata</italic>, an Unrecognized Opportunistic Fungal Pathogen10.1128/mBio.02309-142150-7511https://doaj.org/article/4a702ff7c1c74946b00db0de3e5234642014-12-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mBio.02309-14https://doaj.org/toc/2150-7511ABSTRACT Rapidly fatal cases of invasive fungal infections due to a fungus later identified as Saprochaete clavata were reported in France in May 2012. The objectives of this study were to determine the clonal relatedness of the isolates and to investigate possible sources of contamination. A nationwide alert was launched to collect cases. Molecular identification methods, whole-genome sequencing (WGS), and clone-specific genotyping were used to analyze recent and historical isolates, and a case-case study was performed. Isolates from thirty cases (26 fungemias, 22 associated deaths at day 30) were collected between September 2011 and October 2012. Eighteen cases occurred within 8 weeks (outbreak) in 10 health care facilities, suggesting a common source of contamination, with potential secondary cases. Phylogenetic analysis identified one clade (clade A), which accounted for 16/18 outbreak cases. Results of microbiological investigations of environmental, drug, or food sources were negative. Analysis of exposures pointed to a medical device used for storage and infusion of blood products, but no fungal contamination was detected in the unused devices. Molecular identification of isolates from previous studies demonstrated that S. clavata can be found in dairy products and has already been involved in monocentric outbreaks in hematology wards. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen. This report also underlines further the potential of WGS for investigation of outbreaks due to uncommon fungal pathogens. IMPORTANCE Several cases of rapidly fatal infections due to the fungus Saprochaete clavata were reported in France within a short period of time in three health care facilities, suggesting a common source of contamination. A nationwide alert collected 30 cases over 1 year, including an outbreak of 18 cases over 8 weeks. Whole-genome sequencing (WGS) was used to analyze recent and historical isolates and to design a clade-specific genotyping method that uncovered a clone associated with the outbreak, thus allowing a case-case study to analyze the risk factors associated with infection by the clone. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen.Sophie VauxAlexis CriscuoloMarie Desnos-OllivierLaure DiancourtChloé TarnaudMatthias VandenbogaertSylvain BrisseBruno CoignardFrançoise DromerAmerican Society for MicrobiologyarticleMicrobiologyQR1-502ENmBio, Vol 5, Iss 6 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Microbiology QR1-502
spellingShingle	Microbiology QR1-502 Sophie Vaux Alexis Criscuolo Marie Desnos-Ollivier Laure Diancourt Chloé Tarnaud Matthias Vandenbogaert Sylvain Brisse Bruno Coignard Françoise Dromer Multicenter Outbreak of Infections by <italic toggle="yes">Saprochaete clavata</italic>, an Unrecognized Opportunistic Fungal Pathogen
description	ABSTRACT Rapidly fatal cases of invasive fungal infections due to a fungus later identified as Saprochaete clavata were reported in France in May 2012. The objectives of this study were to determine the clonal relatedness of the isolates and to investigate possible sources of contamination. A nationwide alert was launched to collect cases. Molecular identification methods, whole-genome sequencing (WGS), and clone-specific genotyping were used to analyze recent and historical isolates, and a case-case study was performed. Isolates from thirty cases (26 fungemias, 22 associated deaths at day 30) were collected between September 2011 and October 2012. Eighteen cases occurred within 8 weeks (outbreak) in 10 health care facilities, suggesting a common source of contamination, with potential secondary cases. Phylogenetic analysis identified one clade (clade A), which accounted for 16/18 outbreak cases. Results of microbiological investigations of environmental, drug, or food sources were negative. Analysis of exposures pointed to a medical device used for storage and infusion of blood products, but no fungal contamination was detected in the unused devices. Molecular identification of isolates from previous studies demonstrated that S. clavata can be found in dairy products and has already been involved in monocentric outbreaks in hematology wards. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen. This report also underlines further the potential of WGS for investigation of outbreaks due to uncommon fungal pathogens. IMPORTANCE Several cases of rapidly fatal infections due to the fungus Saprochaete clavata were reported in France within a short period of time in three health care facilities, suggesting a common source of contamination. A nationwide alert collected 30 cases over 1 year, including an outbreak of 18 cases over 8 weeks. Whole-genome sequencing (WGS) was used to analyze recent and historical isolates and to design a clade-specific genotyping method that uncovered a clone associated with the outbreak, thus allowing a case-case study to analyze the risk factors associated with infection by the clone. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen.
format	article
author	Sophie Vaux Alexis Criscuolo Marie Desnos-Ollivier Laure Diancourt Chloé Tarnaud Matthias Vandenbogaert Sylvain Brisse Bruno Coignard Françoise Dromer
author_facet	Sophie Vaux Alexis Criscuolo Marie Desnos-Ollivier Laure Diancourt Chloé Tarnaud Matthias Vandenbogaert Sylvain Brisse Bruno Coignard Françoise Dromer
author_sort	Sophie Vaux
title	Multicenter Outbreak of Infections by <italic toggle="yes">Saprochaete clavata</italic>, an Unrecognized Opportunistic Fungal Pathogen
title_short	Multicenter Outbreak of Infections by <italic toggle="yes">Saprochaete clavata</italic>, an Unrecognized Opportunistic Fungal Pathogen
title_full	Multicenter Outbreak of Infections by <italic toggle="yes">Saprochaete clavata</italic>, an Unrecognized Opportunistic Fungal Pathogen
title_fullStr	Multicenter Outbreak of Infections by <italic toggle="yes">Saprochaete clavata</italic>, an Unrecognized Opportunistic Fungal Pathogen
title_full_unstemmed	Multicenter Outbreak of Infections by <italic toggle="yes">Saprochaete clavata</italic>, an Unrecognized Opportunistic Fungal Pathogen
title_sort	multicenter outbreak of infections by <italic toggle="yes">saprochaete clavata</italic>, an unrecognized opportunistic fungal pathogen
publisher	American Society for Microbiology
publishDate	2014
url	https://doaj.org/article/4a702ff7c1c74946b00db0de3e523464
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Multicenter Outbreak of Infections by <italic toggle="yes">Saprochaete clavata</italic>, an Unrecognized Opportunistic Fungal Pathogen

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