Prospective genomic surveillance of meticillinresistant Staphylococcus aureus (MRSA) associated with bloodstream infection, England, 1 October 2012 to 30 September 2013

Michelle S. Toleman*, Sandra Reuter, Dorota Jamrozy, Hayley J. Wilson, Beth Blane, Ewan M. Harrison, Francesc Coll, Russell Hope, Angela Kearns, Julian Parkhill, Sharon Peacock, M. Estée Török

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Background: Mandatory reporting of meticillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) has occurred in England for over 15 years. Epidemiological information is recorded, but routine collection of isolates for characterisation has not been routinely undertaken. Ongoing developments in whole-genome sequencing (WGS) have demonstrated its value in outbreak investigations and for determining the spread of antimicrobial resistance and bacterial population structure. Benefits of adding genomics to routine epidemiological MRSA surveillance are unknown. Aim: To determine feasibility and potential utility of adding genomics to epidemiological surveillance of MRSA. Methods: We conducted an epidemiological and genomic survey of MRSA BSI in England over a 1-year period (1 October 2012-30 September 2013). Results: During the study period, 903 cases of MRSA BSI were reported; 425 isolates were available for sequencing of which, 276 (65%) were clonal complex (CC) 22. Addition of 64 MRSA genomes from published outbreak investigations showed that the study genomes could provide context for outbreak isolates and supported cluster identification. Comparison to other MRSA genome collections demonstrated variation in clonal diversity achieved through different sampling strategies and identified potentially high-risk clones e.g. USA300 and local expansion of CC5 MRSA in South West England. Conclusions: We demonstrate the potential utility of combined epidemiological and genomic MRSA BSI surveillance to determine the national population structure of MRSA, contextualise previous MRSA outbreaks, and detect potentially highrisk lineages. These findings support the integration of epidemiological and genomic surveillance for MRSA BSI as a step towards a comprehensive surveillance programme in England.

Original languageEnglish
Article number1800215
JournalEurosurveillance
Volume24
Issue number4
DOIs
Publication statusPublished - 24 Jan 2019

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© 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

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