TY - JOUR
T1 - Longitudinal genomic surveillance of MRSA in the UK reveals transmission patterns in hospitals and the community
AU - Coll, Francesc
AU - Harrison, Ewan M.
AU - Toleman, Michelle S.
AU - Reuter, Sandra
AU - Raven, Kathy E.
AU - Blane, Beth
AU - Palmer, Beverley
AU - Kappeler, A. Ruth M.
AU - Brown, Nicholas M.
AU - Török, M. Estée
AU - Parkhill, Julian
AU - Peacock, Sharon
N1 - Publisher Copyright:
Copyright © 2017 The Authors, some rights reserved.
PY - 2017/10/25
Y1 - 2017/10/25
N2 - Genome sequencing has provided snapshots of the transmission of methicillin-resistant Staphylococcus aureus (MRSA) during suspected outbreaks in isolated hospital wards. Scale-up to populations is now required to establish the full potential of this technology for surveillance. We prospectively identified all individuals over a 12-month period who had at least one MRSA-positive sample processed by a routine diagnostic microbiology laboratory in the East of England, which received samples from three hospitals and 75 general practitioner (GP) practices. We sequenced at least 1 MRSA isolate from 1465 individuals (2282 MRSA isolates) and recorded epidemiological data. An integrated epidemiological and phylogenetic analysis revealed 173 transmission clusters containing between 2 and 44 cases and involving 598 people (40.8%). Of these, 118 clusters (371 people) involved hospital contacts alone, 27 clusters (72 people) involved community contacts alone, and 28 clusters (157 people) had both types of contact. Community- and hospital-associated MRSA lineages were equally capable of transmission in the community, with instances of spread in households, long-term care facilities, and GP practices. Our study provides a comprehensive picture of MRSA transmission in a sampled population of 1465 people and suggests the need to review existing infection control policy and practice.
AB - Genome sequencing has provided snapshots of the transmission of methicillin-resistant Staphylococcus aureus (MRSA) during suspected outbreaks in isolated hospital wards. Scale-up to populations is now required to establish the full potential of this technology for surveillance. We prospectively identified all individuals over a 12-month period who had at least one MRSA-positive sample processed by a routine diagnostic microbiology laboratory in the East of England, which received samples from three hospitals and 75 general practitioner (GP) practices. We sequenced at least 1 MRSA isolate from 1465 individuals (2282 MRSA isolates) and recorded epidemiological data. An integrated epidemiological and phylogenetic analysis revealed 173 transmission clusters containing between 2 and 44 cases and involving 598 people (40.8%). Of these, 118 clusters (371 people) involved hospital contacts alone, 27 clusters (72 people) involved community contacts alone, and 28 clusters (157 people) had both types of contact. Community- and hospital-associated MRSA lineages were equally capable of transmission in the community, with instances of spread in households, long-term care facilities, and GP practices. Our study provides a comprehensive picture of MRSA transmission in a sampled population of 1465 people and suggests the need to review existing infection control policy and practice.
UR - http://www.scopus.com/inward/record.url?scp=85032728452&partnerID=8YFLogxK
U2 - 10.1126/scitranslmed.aak9745
DO - 10.1126/scitranslmed.aak9745
M3 - Article
C2 - 29070701
AN - SCOPUS:85032728452
SN - 1946-6234
VL - 9
JO - Science Translational Medicine
JF - Science Translational Medicine
IS - 413
M1 - eaak9745
ER -