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Journal of Clinical Microbiology, November 2004, p. 5109-5120, Vol. 42, No. 11
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.11.5109-5120.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Genetic Diversity of Human Pathogenic Members of the Fusarium oxysporum Complex Inferred from Multilocus DNA Sequence Data and Amplified Fragment Length Polymorphism Analyses: Evidence for the Recent Dispersion of a Geographically Widespread Clonal Lineage and Nosocomial Origin

Kerry O'Donnell,^1* Deanna A. Sutton,² Michael G. Rinaldi,² Karen C. Magnon,³ Patricia A. Cox,⁴ Sanjay G. Revankar,^2, Stephen Sanche,^2, David M. Geiser,⁵ Jean H. Juba,⁵ Jo-Anne H. van Burik,⁶ Arvind Padhye,⁷ Elias J. Anaissie,⁸ Andrea Francesconi,⁹ Thomas J. Walsh,⁹ and Jody S. Robinson¹

National Center for Agricultural Utilization Research, Agriculture Research Service, U.S. Department of Agriculture, Peoria, Illinois,¹ Department of Pathology, University of Texas Health Science Center,² Baptist Hospital,³ 11503 Woollcott, San Antonio, Texas,⁴ Department of Plant Pathology, The Pennsylvania State University, University Park, Pennsylvania,⁵ Division of Infectious Diseases, University of Minnesota, Minneapolis, Minnesota,⁶ Centers for Disease Control and Prevention, Atlanta, Georgia,⁷ University of Arkansas for Medical Sciences, Little Rock, Arkansas,⁸ Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland⁹

Received 11 February 2004/ Returned for modification 29 March 2004/ Accepted 14 July 2004

Fusarium oxysporum is a phylogenetically diverse monophyletic complex of filamentous ascomycetous fungi that are responsible for localized and disseminated life-threatening opportunistic infections in immunocompetent and severely neutropenic patients, respectively. Although members of this complex were isolated from patients during a pseudoepidemic in San Antonio, Tex., and from patients and the water system in a Houston, Tex., hospital during the 1990s, little is known about their genetic relatedness and population structure. This study was conducted to investigate the global genetic diversity and population biology of a comprehensive set of clinically important members of the F. oxysporum complex, focusing on the 33 isolates from patients at the San Antonio hospital and on strains isolated in the United States from the water systems of geographically distant hospitals in Texas, Maryland, and Washington, which were suspected as reservoirs of nosocomial fusariosis. In all, 18 environmental isolates and 88 isolates from patients spanning four continents were genotyped. The major finding of this study, based on concordant results from phylogenetic analyses of multilocus DNA sequence data and amplified fragment length polymorphisms, is that a recently dispersed, geographically widespread clonal lineage is responsible for over 70% of all clinical isolates investigated, including all of those associated with the pseudoepidemic in San Antonio. Moreover, strains of the clonal lineage recovered from patients were conclusively shown to genetically match those isolated from the hospital water systems of three U.S. hospitals, providing support for the hypothesis that hospitals may serve as a reservoir for nosocomial fusarial infections.

Present address: Dallas VA Medical Center, Division of Infectious Diseases, Dallas, TX 75216.

Present address: Royal University Hospital, Division of Infectious Diseases, Saskatoon, Saskatchewan S7N 0W8, Canada.

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