Longitudinal genomic surveillance of MRSA in the UK reveals transmission patterns in hospitals and the community

Francesc Coll*, Ewan M. Harrison, Michelle S. Toleman, Sandra Reuter, Kathy E. Raven, Beth Blane, Beverley Palmer, A. Ruth M. Kappeler, Nicholas M. Brown, M. Estée Török, Julian Parkhill, Sharon Peacock

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

56 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article numbereaak9745
JournalScience Translational Medicine
Volume9
Issue number413
DOIs
Publication statusPublished - 25 Oct 2017

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Copyright © 2017 The Authors, some rights reserved.

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