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12/15

Does genomics give extra information?

What does this type of analysis enable that other typing methods for this organism would not?

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What does this type of analysis enable that other typing methods for this organism would not?

  • When the 944 genes that are present in all the isolates are used to construct the network, the highest resolution is reached – this shows that case 1 and close contact 1 are still unresolvable and that cases 3 and 6 and the 2 remote cases form another cluster which is identified as the outbreak strain. These two clusters are more closely related to each other and to UK reference strain than they are to the other genomes in the analysis.

  • The very-high-resolution information available from WGS data enabled the investigation of short-chain transmission by comparing closely related isolates with the disease-causing reference genome.

  • The relatively large number of genetic changes seen within closely related isolate pairs seems unlikely to have been accumulated during the course of the outbreak but was more likely to be due to the variation in the population of organisms that were circulating in carriage at that time.

  • This level of variation was present in two of the three strains examined; suggesting that infection of individuals with a number of closely related but distinct variants may be common with the meningococcus.

  • While this seems the most likely explanation, it is still possible that these changes occurred during the outbreak. With repeated use of this technology these uncertainties of interpretation will be resolved.

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