Absence of Patient-to-Patient Intrahospital Transmission of Staphylococcus aureus as Determined by Whole-Genome Sequencing
Absence of Patient-to-Patient Intrahospital Transmission of Staphylococcus aureus as Determined by Whole-Genome Sequencing
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DOI：
10.1128/mbio.01692-14
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发表时间：
2014-09-01
期刊：
影响因子：
6.4
通讯作者：
Musser, James M.
中科院分区：
文献类型：
--
作者：
Long, S. Wesley;Beres, Stephen B.;Musser, James M.
病原体的医院传播是一项重大的卫生保健挑战。耐抗生素菌株的日益蔓延对公共卫生构成持续威胁。以往的金黄色葡萄球菌传播研究主要集中在无症状携带者之间的金黄色葡萄球菌传播，或使用低分辨率分型方法，如多位点序列分型（MLST）或spa分型。为了利用高分辨率遗传分析确定院内患者之间的传播，我们对来自无菌部位感染的连续398株金黄色葡萄球菌进行了基因组测序。在6个月的时间里，从休斯顿卫理公会医院系统的四家医院收集了金黄色葡萄球菌菌株。重要的是，我们没有发现金黄色葡萄球菌在无菌部位感染患者之间传播的证据。院内传播的缺乏可能反映了医院环境中日常传播事件与更频繁研究的爆发情景之间的根本差异。以往的研究表明，金黄色葡萄球菌的院内传播是常见的。我们的数据揭示了一个意想不到的缺乏证据的院内传播金黄色葡萄球菌患者之间的侵袭性感染。这一发现对医院感染控制和公共卫生工作具有重要意义。此外，我们的数据表明，社区中存在高度相关的金黄色葡萄球菌菌株池，这可能使暴发调查复杂化。
Nosocomial transmission of pathogens is a major health care challenge. The increasing spread of antibiotic-resistant strains represents an ongoing threat to public health. Previous Staphylococcus aureus transmission studies have focused on transmission of S. aureus between asymptomatic carriers or used low-resolution typing methods such as multilocus sequence typing (MLST) or spa typing. To identify patient-to-patient intrahospital transmission using high-resolution genetic analysis, we sequenced the genomes of a consecutive set of 398 S. aureus isolates from sterile-site infections. The S. aureus strains were collected from four hospitals in the Houston Methodist Hospital System over a 6-month period. Importantly, we discovered no evidence of transmission of S. aureus between patients with sterile-site infections. The lack of intrahospital transmission may reflect a fundamental difference between day-to-day transmission events in the hospital setting and the more frequently studied outbreak scenarios.IMPORTANCE Previous studies have suggested that nosocomial transmission of S. aureus is common. Our data revealed an unexpected lack of evidence for intrahospital transmission of S. aureus between patients with invasive infections. This finding has important implications for hospital infection control and public health efforts. In addition, our data demonstrate that highly related pools of S. aureus strains exist in the community which may complicate outbreak investigations.