Systematic surveillance detects multiple silent introductions and household transmission of methicillin-resistant Staphylococcus aureus USA300 in the east of England
Brown, Nicholas M
Török, M Estée
The Journal of Infectious Diseases
Oxford University Press
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Toleman, M., Reuter, S., Coll, F., Harrison, E., Blane, B., Brown, N. M., Török, M. E., et al. (2016). Systematic surveillance detects multiple silent introductions and household transmission of methicillin-resistant Staphylococcus aureus USA300 in the east of England. The Journal of Infectious Diseases, 214 447-453. https://doi.org/10.1093/infdis/jiw166
Background. The spread of USA300 methicillin-resistant Staphylococcus aureus (MRSA) across the United States (US) resulted in an epidemic of infections. In Europe, only sporadic cases or small clusters of USA300 infections are described and its prevalence in England is unknown. We conducted prospective surveillance for USA300 in the east of England. Methods. We undertook a 12-month prospective observational cohort study of all individuals with MRSA isolated from community and hospital samples submitted to a microbiology laboratory. At least one MRSA isolate from each individual was whole-genome sequenced. USA300 was identified based on sequence analysis, and phylogenetic comparisons were made between these and USA300 genomes from the US. Results. Between April 2012-April 2013, we sequenced 2,283 MRSA isolates (carriage screens and clinical samples) from 1,465 individuals. USA300 was isolated from 24 (1.6%) cases. Ten cases (42%) had skin and soft tissue infection and two cases had invasive disease. Phylogenetic analyses identified multiple introductions and household transmission of USA300. Conclusions. Use of a diagnostic laboratory as a sentinel for surveillance has identified repeated introductions of USA300 into the east of England in 2012-2013, with evidence for limited transmission. Our results show how systematic surveillance could provide an early-warning of strain emergence and dissemination.
This work was supported by grants from the UK Clinical Research Collaboration Translational Infection Research Initiative, and the Medical Research Council (Grant Number G1000803) with contributions to the Grant from the Biotechnology and Biological Sciences Research Council, the National Institute for Health Research on behalf of the Department of Health, and the Chief Scientist Office of the Scottish Government Health Directorate (to Prof. Peacock); by a Healthcare Infection Society Major Research Grant (to Prof. Peacock), and by Wellcome Trust grant number 098051 awarded to the Wellcome Trust Sanger Institute. MST is a Wellcome Trust Clinical PhD Fellow. MET is a Clinician Scientist Fellow, supported by the Academy of Medical Sciences and the Health Foundation, and by the National Institute for Health Research Cambridge Biomedical Research Centre.
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External DOI: https://doi.org/10.1093/infdis/jiw166
This record's URL: https://www.repository.cam.ac.uk/handle/1810/255813
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