期刊
GENOME RESEARCH
卷 25, 期 1, 页码 111-118出版社
COLD SPRING HARBOR LAB PRESS, PUBLICATIONS DEPT
DOI: 10.1101/gr.174730.114
关键词
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资金
- UKCRC Translational Infection Research (TIR) Initiative
- Medical Research Council [G1000803]
- Biotechnology and Biological Sciences Research Council
- National Institute for Health Research, Department of Health
- Chief Scientist Office of the Scottish Government Health Directorate
- Wellcome Trust [098051]
- NIHR Cambridge Biomedical Research Centre
- Australian National Health and Medical Research Council [1065736]
- MRC [MR/K010174/1, G1000803] Funding Source: UKRI
- Medical Research Council [MR/K010174/1, MR/K010174/1B] Funding Source: researchfish
- National Institute for Health Research [HPRU-2012-10080] Funding Source: researchfish
- Wellcome Trust [098600/Z/12/Z] Funding Source: researchfish
Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of nosocomial infection. Whole-genome sequencing of MRSA has been used to define phylogeny and transmission in well-resourced healthcare settings, yet the greatest burden of nosocomial infection occurs in resource-restricted settings where barriers to transmission are lower. Here, we study the flux and genetic diversity of MRSA on ward and individual patient levels in a hospital where transmission was common. We repeatedly screened all patients on two intensive care units for MRSA carriage over a 3-mo period. All MRSA belonged to multilocus sequence type 239 (ST 239). We defined the population structure and charted the spread of MRSA by sequencing 79 isolates from 46 patients and five members of staff, including the first MRSA-positive screen isolates and up to two repeat isolates where available. Phylogenetic analysis identified a flux of distinct ST 239 clades over time in each intensive care unit. In total, five main clades were identified, which varied in the carriage of plasmids encoding antiseptic and antimicrobial resistance determinants. Sequence data confirmed intra-and interwards transmission events and identified individual patients who were colonized by more than one clade. One patient on each unit was the source of numerous transmission events, and deep sampling of one of these cases demonstrated colonization with a cloud of related MRSA variants. The application of whole-genome sequencing and analysis provides novel insights into the transmission of MRSA in under-resourced healthcare settings and has relevance to wider global health.
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