Transmission and microevolution of methicillin-resistant Staphylococcus aureus ST88 strain among patients, healthcare workers, and household contacts at a trauma and orthopedic ward.
Transmission and microevolution of methicillin-resistant Staphylococcus aureus ST88 strain among patients, healthcare workers, and household contacts at a trauma and orthopedic ward.
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DOI：
10.3389/fpubh.2022.1053785
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发表时间：
2022
影响因子：
5.2
通讯作者：
Chen Y
中科院分区：
文献类型：
--
作者：
Sun L;Zhuang H;Di L;Ling X;Yin Y;Wang Z;Chen M;Jiang S;Chen Y;Zhu F;Wang H;Ji S;Sun L;Wu D;Yu Y;Chen Y
耐甲氧西林金黄色葡萄球菌（MRSA）引起的手术部位感染（ssi）是一个重要的临床问题。了解MRSA的传播方式对其预防和控制具有重要意义。我们调查了在创伤和骨科医院病房的MRSA爆发的传播模式。临床资料收集于2015年1月1日至2019年12月31日在创伤和骨科病房感染MRSA的患者（n = 9）。对病房（18例）、患者（48例）、医务人员（23例）及其家属（5例）进行MRSA筛查。采用新一代测序和系统发育分析研究了MRSA分离株的传播模式。分析菌株的耐药基因、质粒和单核苷酸变异，以评估引起ssi的MRSA菌株的微进化。MRSA定植阳性的医生被要求暂停他的医疗活动，以阻止MRSA的传播。我们调查了9例MRSA感染患者，其中3例患者被诊断为SSI，并因持续MRSA感染而长期住院。经筛选，环境样品中未检出MRSA分离株。负责MRSA致SSI患者的外科医生及其儿子MRSA定殖阳性。来自儿子的MRSA与MRSA诱导的ssi患者中检测到的8-9个单核苷酸变异株密切相关，而在外科医生的鼻腔中检测到三种不同spa类型的ST88-MRSA分离株。比较基因组分析显示，ST88-MRSA分离株在传播过程中获得了与细胞壁合成、定植、代谢和毒力相关的基因突变。暂停该外科医生的医疗活动阻断了MRSA感染在该病房的传播。社区相关的MRSA克隆可侵入医院并引起严重的术后医院感染。在卫生工作者家庭中进一步监测耐甲氧西林金黄色葡萄球菌可防止耐甲氧西林金黄色葡萄球菌从定植到感染的转变。
Surgical sites infections (SSIs) caused by Methicillin-resistant Staphylococcus aureus (MRSA) constitute a major clinical problem. Understanding the transmission mode of MRSA is important for its prevention and control. We investigated the transmission mode of a MRSA outbreak in a trauma and orthopedic hospital ward. Clinical data were collected from patients (n = 9) with MRSA infection in a trauma and orthopedic ward from January 1, 2015 to December 31, 2019. The wards (n = 18), patients (n = 48), medical staff (n = 23), and their households (n = 5) were screened for MRSA. The transmission mode of MRSA isolates was investigated using next-generation sequencing and phylogenetic analyses. The resistance genes, plasmids, and single-nucleotide variants of the isolates were analyzed to evaluate microevolution of MRSA isolates causing SSIs. The MRSA colonization-positive doctor was asked to suspend his medical activities to stop MRSA spread. Nine MRSA infected patients were investigated, of which three patients were diagnosed with SSI and had prolonged hospitalization due to the persistent MRSA infection. After screening, MRSA isolates were not detected in environmental samples. The surgeon in charge of the patients with SSI caused by MRSA and his son were positive for MRSA colonization. The MRSA from the son was closely related to the isolates detected in MRSA-induced SSIs patients with 8–9 single-nucleotide variants, while ST88-MRSA isolates with three different spa types were detected in the surgeon's nasal cavity. Comparative genomic analysis showed that ST88-MRSA isolates acquired mutations in genes related to cell wall synthesis, colonization, metabolism, and virulence during their transmission. Suspending the medical activity of this surgeon interrupted the spread of MRSA infection in this ward. Community-associated MRSA clones can invade hospitals and cause severe postoperative nosocomial infections. Further MRSA surveillance in the households of health workers may prevent the transition of MRSA from colonization to infection.
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影响因子：
4.9
作者：
Komatsuzawa, H;Sugai, M;Suginaka, H
通讯作者：
Suginaka, H
影响因子：
56.9
作者：
CALIGIURI, MG;BAUERLE, R
通讯作者：
BAUERLE, R
影响因子：
5.2
作者：
Abdulgader SM;Shittu AO;Nicol MP;Kaba M
通讯作者：
Kaba M
影响因子：
4.2
作者：
Ajayi C;Åberg E;Askarian F;Sollid JUE;Johannessen M;Hanssen AM
通讯作者：
Hanssen AM
影响因子：
4.8
作者：
Jacobitz, Alex W.;Wereszczynski, Jeff;Clubb, Robert T.
通讯作者：
Clubb, Robert T.