{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:59:54Z","timestamp":1792403994909,"version":"4.4.0"},"reference-count":21,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2012,12,11]]},"published-print":{"date-parts":[[2013]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Epidemiological investigations of Legionnaires\u2019 disease outbreaks rely on the rapid identification and typing of clinical and environmental\n                      <jats:italic>Legionella<\/jats:italic>\n                      isolates in order to identify and control the source of infection. Rapid bacterial whole-genome sequencing (WGS) is an emerging technology that has the potential to rapidly discriminate outbreak from non-outbreak isolates in a clinically relevant time frame.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a pilot study to determine the feasibility of using bacterial WGS to differentiate outbreak from non-outbreak isolates collected during an outbreak of Legionnaires\u2019 disease. Seven\n                      <jats:italic>Legionella<\/jats:italic>\n                      isolates (three clinical and four environmental) were obtained from the reference laboratory and sequenced using the Illumina MiSeq platform at Addenbrooke's Hospital, Cambridge. Bioinformatic analysis was performed blinded to the epidemiological data at the Wellcome Trust Sanger Institute.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We were able to distinguish outbreak from non-outbreak isolates using bacterial WGS, and to confirm the probable environmental source. Our analysis also highlighted constraints, which were the small number of\n                      <jats:italic>Legionella pneumophila<\/jats:italic>\n                      isolates available for sequencing, and the limited number of published genomes for comparison.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      We have demonstrated the feasibility of using rapid WGS to investigate an outbreak of Legionnaires\u2019 disease. Future work includes building larger genomic databases of\n                      <jats:italic>L pneumophila<\/jats:italic>\n                      from both clinical and environmental sources, developing automated data interpretation software, and conducting a cost\u2013benefit analysis of WGS versus current typing methods.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2012-002175","type":"journal-article","created":{"date-parts":[[2013,1,10]],"date-time":"2013-01-10T21:49:06Z","timestamp":1357854546000},"page":"e002175","source":"Crossref","is-referenced-by-count":103,"title":["A pilot study of rapid whole-genome sequencing for the investigation of a\n                    <i>Legionella<\/i>\n                    outbreak"],"prefix":"10.1136","volume":"3","author":[{"given":"Sandra","family":"Reuter","sequence":"first","affiliation":[{"name":"The Wellcome Trust Sanger Institute, Hinxton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy G","family":"Harrison","sequence":"additional","affiliation":[{"name":"Respiratory and Systemic Infection Laboratory, Health Protection Agency Centre for Infections, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio U","family":"K\u00f6ser","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK"},{"name":"Cambridge Public Health and Microbiology Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Ellington","sequence":"additional","affiliation":[{"name":"Cambridge Public Health and Microbiology Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey P","family":"Smith","sequence":"additional","affiliation":[{"name":"Illumina Cambridge Ltd, Saffron Walden, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Parkhill","sequence":"additional","affiliation":[{"name":"The Wellcome Trust Sanger Institute, Hinxton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon J","family":"Peacock","sequence":"additional","affiliation":[{"name":"The Wellcome Trust Sanger Institute, Hinxton, UK"},{"name":"Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK"},{"name":"Cambridge Public Health and Microbiology Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"},{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen D","family":"Bentley","sequence":"additional","affiliation":[{"name":"The Wellcome Trust Sanger Institute, Hinxton, UK"},{"name":"Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Est\u00e9e","family":"T\u00f6r\u00f6k","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK"},{"name":"Cambridge Public Health and Microbiology Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"},{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,1,9]]},"reference":[{"key":"2025121402382399000_3.1.e002175.1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e328336835b"},{"key":"2025121402382399000_3.1.e002175.2","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1128\/jcm.28.2.242-245.1990","article-title":"Molecular typing of nosocomial isolates of Legionella 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