| Autor: |
Locke T; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; The Florey Institute of Infection, The University of Sheffield, Sheffield, UK., Siribaddana S; Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka., Jayaweera JAAS; Department of Microbiology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka., Suligoy CM; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; The Florey Institute of Infection, The University of Sheffield, Sheffield, UK., de Silva TI; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; The Florey Institute of Infection, The University of Sheffield, Sheffield, UK., Corrigan RM; The Florey Institute of Infection, The University of Sheffield, Sheffield, UK.; School of Biosciences, The University of Sheffield, Sheffield, UK.; Present address: The School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland., Darton TC; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; The Florey Institute of Infection, The University of Sheffield, Sheffield, UK. |
| Abstrakt: |
Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of infection in both community and healthcare settings, and the household may be a central component linking these two environments. Strategies to prevent S. aureus transmission and thereby reduce the risk of infection must be informed by a detailed understanding of local epidemiology. These data are typically lacking in many low- and middle-income countries. Therefore, we aimed to investigate the circulation of infecting S. aureus strains in Sri Lanka, with a focus on the community and healthcare interface. A prospective longitudinal cohort study was performed between July and December 2021. Index patients with S. aureus infection and up to four of their household contacts were enrolled in the study. Colonization was assessed by sampling participants' nose and axilla at two time points over 3 months of follow-up. Whole-genome sequencing (WGS) was used to characterize isolates and assess strain similarity to identify transmission episodes and environmental clusters. A total of 153 participants were recruited, including 42 S . aureus -positive index patients and 111 household contacts. The baseline prevalence of S. aureus colonization amongst household contacts was 11.7% (13/111), of which 30.8% (4/13) were methicillin-resistant. A total of 88 S . aureus isolates underwent WGS and three multilocus sequence types predominated: ST672, ST5 and ST6. Each type had unique virulence characteristics but was identified in both community and healthcare environments. Colonization of household members with the index's infecting strain was not detected. S. aureus is a major cause of morbidity and mortality in low-resource settings such as Sri Lanka, yet little is known about risk factors and transmission networks. In this descriptive study, we have identified a small number of strains that appear to be well established and capable of causing both severe infection and asymptomatic colonization. Transmission of S. aureus did not appear to be occurring frequently in the household, and, therefore, preventative strategies that target high-risk groups may be more successful than universal community-based measures. |
