MRSA transmission on a neonatal intensive care unit: epidemiological and genome-based phylogenetic analyses

Autor: Felix Bröcker, Karin Moelling, Christoph Bührer, Petra Gastmeier, Gerhard Falkenhorst, Brar Piening, Michael Behnke, Justus Benzler, Wolfgang Witte, Jochen Hecht, Matthias Nachtnebel, Michael Kube, Tim Eckmanns, Manuel Dehnert, Franziska Layer, Ulrich Nübel
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Male
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty
Neonatal intensive care unit
Epidemiology
Bacterial diseases
lcsh:Medicine
Biology
medicine.disease_cause
Staphylococcal infections
Microbiology
Infectious Disease Epidemiology
Risk Factors
Intensive care
Intensive Care Units
Neonatal
Microbial Control
Nosocomial infections
medicine
Humans
Intensive care medicine
lcsh:Science
Phylogeny
Staphylococci
Multidisciplinary
Population Biology
Transmission (medicine)
lcsh:R
Case-control study
Infant
Newborn
Outbreak
Genetic Variation
Genomics
Staphylococcal Infections
biochemical phenomena
metabolism
and nutrition
medicine.disease
bacterial infections and mycoses
Methicillin-resistant Staphylococcus aureus
Bacterial Pathogens
Medical Microbiology
Case-Control Studies
Medicine
Infectious diseases
Female
lcsh:Q
Genome
Bacterial
Research Article
Zdroj: PLoS ONE, Vol 8, Iss 1, p e54898 (2013)
PLoS ONE
ISSN: 1932-6203
Popis: BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) may cause prolonged outbreaks of infections in neonatal intensive care units (NICUs). While the specific factors favouring MRSA spread on neonatal wards are not well understood, colonized infants, their relatives, or health-care workers may all be sources for MRSA transmission. Whole-genome sequencing may provide a new tool for elucidating transmission pathways of MRSA at a local scale. METHODS AND FINDINGS: We applied whole-genome sequencing to trace MRSA spread in a NICU and performed a case-control study to identify risk factors for MRSA transmission. MRSA genomes had accumulated sequence variation sufficiently fast to reflect epidemiological linkage among individual patients, between infants and their mothers, and between infants and staff members, such that the relevance of individual nurses' nasal MRSA colonization for prolonged transmission could be evaluated. In addition to confirming previously reported risk factors, we identified an increased risk of transmission from infants with as yet unknown MRSA colonisation, in contrast to known MRSA-positive infants. CONCLUSIONS: The integration of epidemiological (temporal, spatial) and genomic data enabled the phylogenetic testing of several hypotheses on specific MRSA transmission routes within a neonatal intensive-care unit. The pronounced risk of transmission emanating from undetected MRSA carriers suggested that increasing the frequency or speed of microbiological diagnostics could help to reduce transmission of MRSA.
Databáze: OpenAIRE
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