MRSA Transmission Dynamics Among Interconnected Acute, Intermediate-Term, and Long-Term Healthcare Facilities in Singapore
MRSA Transmission Dynamics Among Interconnected Acute, Intermediate-Term, and Long-Term Healthcare Facilities in Singapore
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DOI：
10.1093/cid/cix072
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发表时间：
2017-05-15
影响因子：
11.8
通讯作者：
Holden, Matthew T. G.
中科院分区：
文献类型：
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作者：
Chow, Angela;Lim, Vanessa W.;Holden, Matthew T. G.
背景。耐甲氧西林金黄色葡萄球菌（MRSA）是最常见的与医疗保健相关的多重耐药微生物。尽管急症护理医院（ACHs）和中长期护理机构（iltcf）之间存在相互联系，但MRSA在医疗机构之间的传播动态尚不清楚。我们在新加坡的一个由ACH和5个密切相关的iltcf组成的网络中进行了一项横断面研究。2014年，共有1700名住院患者接受了为期6周的MRSA筛查。对MRSA分离株进行了全基因组测序，对60个核心基因组单核苷酸多态性进行了两两单核苷酸多态性（汉明距离）截断，用于确定3个主要克隆的近期传播簇（分支）。MRSA在中期（29.9%）和长期（20.4%）护理机构的患病率明显高于ACH （11.8%）
Background. Methicillin-resistant Staphylococcus aureus (MRSA) is the most common healthcare-associated multidrug-resistant organism. Despite the interconnectedness between acute care hospitals (ACHs) and intermediate-and long-term care facilities (ILTCFs), the transmission dynamics of MRSA between healthcare settings is not well understood.Methods. We conducted a cross-sectional study in a network comprising an ACH and 5 closely affiliated ILTCFs in Singapore. A total of 1700 inpatients were screened for MRSA over a 6-week period in 2014. MRSA isolates underwent whole-genome sequencing, with a pairwise single-nucleotide polymorphism (Hamming distance) cutoff of 60 core genome single-nucleotide polymorphisms used to define recent transmission clusters (clades) for the 3 major clones.Results. MRSA prevalence was significantly higher in intermediate-term (29.9%) and long-term (20.4%) care facilities than in the ACH (11.8%) (P