Molecular surveillance of methicillin-resistant Staphylococcus aureus genomes in hospital unexpectedly reveals discordance between temporal and genetic clustering
Molecular surveillance of methicillin-resistant Staphylococcus aureus genomes in hospital unexpectedly reveals discordance between temporal and genetic clustering
复制标题
DOI：
10.1016/j.ajic.2020.06.180
复制
发表时间：
2021-01-01
影响因子：
4.9
通讯作者：
Lamers, Susanna L.
中科院分区：
文献类型：
--
作者：
Rose, Rebecca;Nolan, David J.;Lamers, Susanna L.
背景：本研究的目的是利用全基因组测序(WGS)来确定耐甲氧西林金黄色葡萄球菌感染之间的来源和联系。方法：从佛罗里达大学杰克逊维尔分校6个月内确诊的所有MRSA感染患者中获得56份样本。对样本进行培养和测序；在基于云的自动化平台上分析数据。基因簇定义为3天内5例MRSA病例。结果：共发现7个基因簇，包括15个样本。四个基因簇包含住院时间不重叠的患者(相隔3-10周)，其中3个包含共用同一个单元的患者。我们还发现了5个时间簇，包括23个样本，尽管这些样本都没有遗传关系。讨论：结果表明，时间聚集性可能是遗传连锁的一个不好的指标。基因集群中的患者之间的共同流行病学特征可能指向以前未确定的医院来源。相关菌株的反复观察也与MRSA在周围高危社区内的持续传播一致。结论：WGS是一种有价值的医院感染预防和控制工具。(C)2020感染控制和流行病学专业人员协会。由Elsevier Inc.出版。保留所有权利。
Background: The objective of this study was to identify sources and linkages among methicillin-resistant Staphylococcus aureus infections using whole-genome sequencing (WGS).Methods: A total of 56 samples were obtained from all patients with a confirmed MRSA infection over 6 months at University of Florida-Health Jacksonville. Samples were cultured and sequenced; data was analyzed on an automated cloud-based platform. Genetic Clusters were defined as = 5 MRSA cases over 3 days.Results: We found 7 Genetic Clusters comprising 15 samples. Four Genetic Clusters contained patients with non-overlapping stays (3-10 weeks apart), 3 of which contained patients who shared the same Unit. We also found 5 Temporal Clusters comprising 23 samples, although none of the samples were genetically related. Discussion: Results showed that temporal clustering may be a poor indicator of genetic linkage. Shared epidemiological characteristics between patients in Genetic Clusters may point toward previously unidentified hospital sources. Repeated observation of related strains is also consistent with ongoing MRSA transmission within the surrounding high-risk community.Conclusions: WGS is a valuable tool for hospital infection prevention and control. (C) 2020 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.