Strain-level overlap between infant and hospital fungal microbiomes revealed through de novo assembly of eukaryotic genomes from metagenomes

Eukaryotes are a leading cause of nosocomial infections in neonates, but their diversity and population heterogeneity are rarely investigated. This has led to an incomplete understanding of eukaryotic strains that colonize infants and of the neonatal intensive care unit (NICU) as a possible source of these strains. Analysis of 1,174 time-series metagenomes from 161 premature infants revealed fungal colonization of 13 infants, primarily in the first two weeks of life. Nearly all 24 NICU samples contained eukaryotes, and the most diverse communities were in NICU sinks. Five of fourteen newly-assembled eukaryotic genomes derived from genomically undescribed species. Purpureocillium lilacinum genomes from infant and NICU samples shared 99.999% average nucleotide identity, highlighting the potential of hospital-associated fungi to colonize hospitalized infants. We quantified zygosity and within-population variation associated with the diploid eukaryotes, and thus defined the genetic reservoirs of eukaryotes in room environments and infants.