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

Autor:	Toleman MS; University of Cambridge, Department of Medicine, Cambridge, United Kingdom.; Wellcome Sanger Institute, Hinxton, United Kingdom.; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom., Reuter S; University of Freiburg, Institute for Infection Prevention and Hospital Epidemiology, Freiburg, Germany., Jamrozy D; Wellcome Sanger Institute, Hinxton, United Kingdom., Wilson HJ; University of Cambridge, Department of Medicine, Cambridge, United Kingdom., Blane B; University of Cambridge, Department of Medicine, Cambridge, United Kingdom., Harrison EM; University of Cambridge, Department of Medicine, Cambridge, United Kingdom.; Wellcome Sanger Institute, Hinxton, United Kingdom., Coll F; London School of Hygiene and Tropical Medicine, London, United Kingdom., Hope RJ; Public Health England, National Infection Service, Colindale, London, United Kingdom., Kearns A; Public Health England, National Infection Service, Colindale, London, United Kingdom., Parkhill J; Wellcome Sanger Institute, Hinxton, United Kingdom., Peacock SJ; University of Cambridge, Department of Medicine, Cambridge, United Kingdom.; Wellcome Sanger Institute, Hinxton, United Kingdom.; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.; London School of Hygiene and Tropical Medicine, London, United Kingdom., Török ME; University of Cambridge, Department of Medicine, Cambridge, United Kingdom.; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.; Public Health England, Clinical Microbiology and Public Health Laboratory, Cambridge, United Kingdom.
Jazyk:	angličtina
Zdroj:	Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin [Euro Surveill] 2019 Jan; Vol. 24 (4).
DOI:	10.2807/1560-7917.ES.2019.24.4.1800215
Abstrakt:	BackgroundMandatory reporting of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) has occurred in England for over 15years. 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.AimTo determine feasibility and potential utility of adding genomics to epidemiological surveillance of MRSA.MethodsWe conducted an epidemiological and genomic survey of MRSA BSI in England over a 1-year period (1 October 2012--30 September 2013).ResultsDuring 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.ConclusionsWe 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 high-risk lineages. These findings support the integration of epidemiological and genomic surveillance for MRSA BSI as a step towards a comprehensive surveillance programme in England.
Databáze:	MEDLINE
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