{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:11:38Z","timestamp":1790467898743,"version":"4.1.0"},"reference-count":37,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T00:00:00Z","timestamp":1409529600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:named-content content-type=\"genus-species\">Exserohilum rostratum<\/jats:named-content>\n            was the cause of most cases of fungal meningitis and other infections associated with the injection of contaminated methylprednisolone acetate produced by the New England Compounding Center (NECC). Until this outbreak, very few human cases of\n            <jats:named-content content-type=\"genus-species\">Exserohilum<\/jats:named-content>\n            infection had been reported, and very little was known about this dematiaceous fungus, which usually infects plants. Here, we report using whole-genome sequencing (WGS) for the detection of single nucleotide polymorphisms (SNPs) and phylogenetic analysis to investigate the molecular origin of the outbreak using 22 isolates of\n            <jats:named-content content-type=\"genus-species\">E. rostratum<\/jats:named-content>\n            retrieved from 19 case patients with meningitis or epidural\/spinal abscesses, 6 isolates from contaminated NECC vials, and 7 isolates unrelated to the outbreak. Our analysis indicates that all 28 isolates associated with the outbreak had nearly identical genomes of 33.8 Mb. A total of 8 SNPs were detected among the outbreak genomes, with no more than 2 SNPs separating any 2 of the 28 genomes. The outbreak genomes were separated from the next most closely related control strain by \u223c136,000 SNPs. We also observed significant genomic variability among strains unrelated to the outbreak, which may suggest the possibility of cryptic speciation in\n            <jats:named-content content-type=\"genus-species\">E. rostratum<\/jats:named-content>\n            .\n          <\/jats:p>","DOI":"10.1128\/jcm.00936-14","type":"journal-article","created":{"date-parts":[[2014,6,21]],"date-time":"2014-06-21T03:54:37Z","timestamp":1403322877000},"page":"3216-3222","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":60,"title":["Whole-Genome Analysis of Exserohilum rostratum from an Outbreak of Fungal Meningitis and Other Infections"],"prefix":"10.1128","volume":"52","author":[{"given":"Anastasia P.","family":"Litvintseva","sequence":"first","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Hurst","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalitha","family":"Gade","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Frace","sequence":"additional","affiliation":[{"name":"Biotechnology Core Facility, Division of Scientific Resources, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remy","family":"Hilsabeck","sequence":"additional","affiliation":[{"name":"Translational Genomics Research Institute, Flagstaff, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Schupp","sequence":"additional","affiliation":[{"name":"Translational Genomics Research Institute, Flagstaff, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Gillece","sequence":"additional","affiliation":[{"name":"Translational Genomics Research Institute, Flagstaff, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandler","family":"Roe","sequence":"additional","affiliation":[{"name":"Translational Genomics Research Institute, Flagstaff, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Smith","sequence":"additional","affiliation":[{"name":"Translational Genomics Research Institute, Flagstaff, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Keim","sequence":"additional","affiliation":[{"name":"Translational Genomics Research Institute, Flagstaff, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn R.","family":"Lockhart","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankar","family":"Changayil","sequence":"additional","affiliation":[{"name":"Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Ryan","family":"Weil","sequence":"additional","affiliation":[{"name":"Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duncan R.","family":"MacCannell","sequence":"additional","affiliation":[{"name":"Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Brandt","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Engelthaler","sequence":"additional","affiliation":[{"name":"Translational Genomics Research Institute, Flagstaff, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","first-page":"839","article-title":"Multistate outbreak of fungal infection associated with injection of methylprednisolone acetate solution from a single compounding pharmacy\u2013United States, 2012","volume":"61","author":"Centers for Disease Control and Prevention","year":"2012","unstructured":"Centers for Disease Control and Prevention. 2012. Multistate outbreak of fungal infection associated with injection of methylprednisolone acetate solution from a single compounding pharmacy\u2013United States, 2012. MMWR Morb. Mortal. Wkly. Rep. 61:839\u2013842.","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1213978"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1212972"},{"key":"e_1_3_2_5_2","first-page":"377","article-title":"Spinal and paraspinal infections associated with contaminated methylprednisolone acetate injections-Michigan, 2012-2013","volume":"62","author":"Centers for Disease Control and Prevention","year":"2013","unstructured":"Centers for Disease Control and Prevention. 2013. Spinal and paraspinal infections associated with contaminated methylprednisolone acetate injections-Michigan, 2012-2013. MMWR Morb. Mortal. Wkly. Rep. 62:377\u2013381.","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1304879"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1212292"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/EC.00046-13"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01000-13"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit808"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpath.2013.05.007"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.24.2.250-259.1986"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-006-0093-3"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fgb.2013.08.016"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/13693780701449425"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/mmy.38.s1.189.197"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2010.01.012"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.7734"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70268-2"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.00157-11"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1702.100620"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0049989"},{"key":"e_1_3_2_23_2","volume-title":"Health Alert Network","author":"Centers for Disease Control and Prevention","year":"2012","unstructured":"Centers for Disease Control and Prevention. 2012. Update: additional contamination identified in medical products from New England Compounding Center, Health Alert Network, vol HAN-0337. CDC, Atlanta, GA."},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1086\/430613"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-61779-089-8_20"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081760"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1101\/gr.8.3.251"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btr507"},{"key":"e_1_3_2_29_2","first-page":"45","volume-title":"Proceedings of the German Conference on Bioinformatics, GBC Braunschweig and University of Bielefeld","author":"Chevreux B","year":"1999","unstructured":"ChevreuxBWetterTSuhaiS. 1999. Genome sequence assembly using trace signals and additional sequence information, p 45\u201356. In Proceedings of the German Conference on Bioinformatics, GBC Braunschweig and University of Bielefeld, Bielefeld, Germany. http:\/\/www.bioinfo.de\/isb\/gcb99\/talks\/chevreux\/main.html."},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/gb-2004-5-2-r12"},{"key":"e_1_3_2_31_2","first-page":"189","article-title":"MEGA: Molecular Evolutionary Genetics Analysis software for microcomputers","volume":"10","author":"Kumar S","year":"1994","unstructured":"KumarSTamuraKNeiM. 1994. MEGA: Molecular Evolutionary Genetics Analysis software for microcomputers. Comput. Appl. Biosci. 10:189\u2013191.","journal-title":"Comput. Appl. 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