Evidence for Elizabethkingia anophelis transmission from mother to infant, Hong Kong

• Published in: Emerging infectious diseases Vol. 21; no. 2; pp. 232 - 241
• Main Authors: Lau, Susanna K P, Wu, Alan K L, Teng, Jade L L, Tse, Herman, Curreem, Shirly O T, Tsui, Stephen K W, Huang, Yi, Chen, Jonathan H K, Lee, Rodney A, Yuen, Kwok-Yung, Woo, Patrick C Y
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.02.2015; Centers for Disease Control and Prevention
• Subjects: Adult; Analysis; Animals; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Culicidae - microbiology; Disease transmission; DNA sequencing; Elizabethkingia anophelis; Evidence for; Female; Flavobacteriaceae - classification; Flavobacteriaceae - drug effects; Flavobacteriaceae - genetics; Flavobacteriaceae Infections - diagnosis; Flavobacteriaceae Infections - drug therapy; Flavobacteriaceae Infections - epidemiology; Flavobacteriaceae Infections - transmission; genome; Genome, Bacterial; Genomes; Genomics; Health aspects; Hong Kong - epidemiology; Humans; Infant; Infant, Newborn; Infants (Newborn); Infectious Disease Transmission, Vertical; Male; Meningitis; Microbial Sensitivity Tests; Molecular Sequence Data; neonatal; Nucleotide sequencing; Phylogeny; Pregnancy; sepsis; Sequence Analysis, DNA; Transmission from Mother to Infant, Hong Kong; vertical; Virulence Factors - genetics; Hong Kong
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2102.140623

Elizabethkingia anophelis, recently discovered from mosquito gut, is an emerging bacterium associated with neonatal meningitis and nosocomial outbreaks. However, its transmission route remains unknown. We use rapid genome sequencing to investigate 3 cases of E. anophelis sepsis involving 2 neonates who had meningitis and 1 neonate's mother who had chorioamnionitis. Comparative genomics revealed evidence for perinatal vertical transmission from a mother to her neonate; the 2 isolates from these patients, HKU37 and HKU38, shared essentially identical genome sequences. In contrast, the strain from another neonate (HKU36) was genetically divergent, showing only 78.6% genome sequence identity to HKU37 and HKU38, thus excluding a clonal outbreak. Comparison to genomes from mosquito strains revealed potential metabolic adaptations in E. anophelis under different environments. Maternal infection, not mosquitoes, is most likely the source of neonatal E. anophelis infections. Our findings highlight the power of genome sequencing in gaining rapid insights on transmission and pathogenesis of emerging pathogens.