期刊
SCIENCE TRANSLATIONAL MEDICINE
卷 9, 期 413, 页码 -出版社
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/scitranslmed.aak9745
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资金
- UK Clinical Research Collaboration Translational Infection Research Initiative
- Medical Research Council [G1000803]
- Biotechnology and Biological Sciences Research Council
- National Institute for Health Research (NIHR) on behalf of the Department of Health
- Chief Scientist Office of the Scottish Government Health Directorate
- Hospital Infection Society Major Research Grant
- Wellcome Trust [098051, 201344/Z/16/Z]
- Academy of Medical Sciences and the Health Foundation
- NIHR Cambridge Biomedical Research Centre
- MRC [G1000803, MR/N029399/1] Funding Source: UKRI
- Wellcome Trust [201344/Z/16/Z] Funding Source: Wellcome Trust
- Academy of Medical Sciences (AMS) [AMS-CSF4-Torok] Funding Source: researchfish
- Medical Research Council [MR/N029399/1, G1000803] Funding Source: researchfish
Genome sequencing has provided snapshots of the transmission of methicillin-resistant Staphylococcus aureus (MRSA) during suspected outbreaks in isolated hospital wards. Scale-up to populations is now required to establish the full potential of this technology for surveillance. We prospectively identified all individuals over a 12-month period who had at least one MRSA-positive sample processed by a routine diagnostic microbiology laboratory in the East of England, which received samples from three hospitals and 75 general practitioner (GP) practices. We sequenced at least 1 MRSA isolate from 1465 individuals (2282 MRSA isolates) and recorded epidemiological data. An integrated epidemiological and phylogenetic analysis revealed 173 transmission clusters containing between 2 and 44 cases and involving 598 people (40.8%). Of these, 118 clusters (371 people) involved hospital contacts alone, 27 clusters (72 people) involved community contacts alone, and 28 clusters (157 people) had both types of contact. Community-and hospital-associated MRSA lineages were equally capable of transmission in the community, with instances of spread in households, long-term care facilities, and GP practices. Our study provides a comprehensive picture of MRSA transmission in a sampled population of 1465 people and suggests the need to review existing infection control policy and practice.
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