Meticillin-resistant Staphylococcus aureus transmission among healthcare workers, patients and the environment in a large acute hospital under non-outbreak conditions investigated using whole-genome sequencing
| Autor: | Anna C. Shore, David C. Coleman, A. Kearney, Peter M. Kinnevey, Megan R. Earls, T.T. Poovelikunnel, Gráinne I. Brennan, Hilary Humphreys |
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| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Methicillin-Resistant Staphylococcus aureus medicine.medical_specialty Health Personnel education medicine.disease_cause Disease Outbreaks Methicillin Internal medicine medicine Humans Typing Acute hospital Whole genome sequencing Cross Infection MRSA colonization Transmission (medicine) business.industry virus diseases Outbreak General Medicine biochemical phenomena metabolism and nutrition Staphylococcal Infections Hospitals Infectious Diseases Meticillin resistant Staphylococcus aureus business Multilocus Sequence Typing |
| Zdroj: | The Journal of hospital infection. 118 |
| ISSN: | 1532-2939 |
| Popis: | Summary Background The role of meticillin-resistant Staphylococcus aureus (MRSA) colonization of healthcare workers (HCWs), patients and the hospital environment in MRSA transmission in non-outbreak settings is poorly understood. Aims To investigate transmission events (TEs) involving HCWs, patients and the environment under non-outbreak conditions in a hospital with a history of endemic MRSA using whole-genome sequencing (WGS). Methods HCW (N = 326) and patient (N = 388) volunteers on nine wards were tested for nasal and oral MRSA colonization over two years. Near-patient environment (N = 1164), high-frequency touch sites (N = 810) and air (N = 445) samples were screened for MRSA. Representative MRSA and clinical isolates were analysed by WGS and core-genome multi-locus sequence typing (cgMLST). Closely related isolates (≤24 allelic differences) were segregated into related isolated groups (RIGs). Findings In total, 155 MRSA were recovered: clinical isolates (N = 41), HCWs (N = 22), patients (N = 37), environmental isolates (N = 55). Nine clonal complexes (CCs) were identified among 110/155 MRSA sequenced with 77/110 assigned to CC22. Seventy-nine MRSA segregated into 17 RIGs. Numerous potential TEs were associated with CC22-MRSA (RIGs 1–15), CC45-MRSA (RIG-16) and CC8-MRSA (RIG-17). RIG-1, (the largest RIG) contained 24 ST22-MRSA-IVh from six HCWs, six patients, four clinical and eight environmental samples recovered over 17 months involving 7/9 wards. TEs involving HCW-to-patient, HCW-to-HCW, patient-to-patient and environmental contamination by HCW/patient isolates were evident. HCW, patient, clinical and environmental isolates were identified in four, nine, seven and 13 RIGs, respectively, with 12/13 of these containing isolates closely related to HCW and/or patient isolates. Conclusions WGS detected numerous potential hospital MRSA TEs involving HCWs, patients and the environment under non-outbreak conditions. |
| Databáze: | OpenAIRE |
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