Coll, Francesc; Harrison, Ewan M; Toleman, Michelle S; Reuter, Sandra; Raven, Kathy E; Blane, Beth; Palmer, Beverley; Kappeler, A Ruth M; Brown, Nicholas M; Török, M Estée; +2 more... Parkhill, Julian; Peacock, Sharon J; (2017) Longitudinal genomic surveillance of MRSA in the UK reveals transmission patterns in hospitals and the community. Science translational medicine, 9 (413). eaak9745-eaak9745. ISSN 1946-6234 DOI: https://doi.org/10.1126/scitranslmed.aak9745
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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.
Item Type | Article |
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Faculty and Department |
Faculty of Infectious and Tropical Diseases > Department of Infection Biology Faculty of Infectious and Tropical Diseases > Department of Infection Biology > Dept of Pathogen Molecular Biology (-2019) |
Research Centre | Antimicrobial Resistance Centre (AMR) |
PubMed ID | 29070701 |
ISI | 413750700002 |
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