The stealthy superbug

the role of asymptomatic enteric carriage in maintaining a long-term hospital outbreak of ST228 methicillin resistant Staphylococcus aureus

Laurence Senn, Olivier Clerc, Giorgio Zanetti, Patrick Basset, Guy Prod'hom, Nicola Gordon, Anna Sheppard, Derrick Crook, Richard James, Harry Arthur Frank Wright Thorpe, Edward Feil, Dominique Blanc

Research output: Contribution to journalArticle

31 Citations (Scopus)
44 Downloads (Pure)

Abstract

Whole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of ST228, rather than repeated introductions of this clone into the hospital. We note that this clone is significantly more frequently recovered from groin and rectal swabs than other clones (P < 0.0001) and is also significantly more transmissible between roommates (P < 0.01). Unrecognized MRSA carriers, together with movements of patients within the hospital, also seem to have played a major role. These atypical colonization and transmission dynamics can help explain how the outbreak was maintained over the long term. This “stealthy” asymptomatic colonization of the gut, combined with heightened transmissibility (potentially reflecting a role for environmental reservoirs), means the dynamics of this outbreak share some properties with enteric pathogens such as vancomycin-resistant enterococci or Clostridium difficile.
Original languageEnglish
Article numbere02039-15
Pages (from-to)1-9
Number of pages9
JournalmBio
Volume7
Issue number1
DOIs
Publication statusPublished - 19 Jan 2016

Cite this

The stealthy superbug : the role of asymptomatic enteric carriage in maintaining a long-term hospital outbreak of ST228 methicillin resistant Staphylococcus aureus. / Senn, Laurence; Clerc, Olivier; Zanetti, Giorgio; Basset, Patrick; Prod'hom, Guy; Gordon, Nicola; Sheppard, Anna; Crook, Derrick; James, Richard; Thorpe, Harry Arthur Frank Wright; Feil, Edward; Blanc, Dominique.

In: mBio, Vol. 7, No. 1, e02039-15, 19.01.2016, p. 1-9.

Research output: Contribution to journalArticle

Senn, L, Clerc, O, Zanetti, G, Basset, P, Prod'hom, G, Gordon, N, Sheppard, A, Crook, D, James, R, Thorpe, HAFW, Feil, E & Blanc, D 2016, 'The stealthy superbug: the role of asymptomatic enteric carriage in maintaining a long-term hospital outbreak of ST228 methicillin resistant Staphylococcus aureus', mBio, vol. 7, no. 1, e02039-15, pp. 1-9. https://doi.org/10.1128/mBio.02039-15
Senn, Laurence ; Clerc, Olivier ; Zanetti, Giorgio ; Basset, Patrick ; Prod'hom, Guy ; Gordon, Nicola ; Sheppard, Anna ; Crook, Derrick ; James, Richard ; Thorpe, Harry Arthur Frank Wright ; Feil, Edward ; Blanc, Dominique. / The stealthy superbug : the role of asymptomatic enteric carriage in maintaining a long-term hospital outbreak of ST228 methicillin resistant Staphylococcus aureus. In: mBio. 2016 ; Vol. 7, No. 1. pp. 1-9.
@article{f539636c15174f7b8508342b28e525f6,
title = "The stealthy superbug: the role of asymptomatic enteric carriage in maintaining a long-term hospital outbreak of ST228 methicillin resistant Staphylococcus aureus",
abstract = "Whole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of ST228, rather than repeated introductions of this clone into the hospital. We note that this clone is significantly more frequently recovered from groin and rectal swabs than other clones (P < 0.0001) and is also significantly more transmissible between roommates (P < 0.01). Unrecognized MRSA carriers, together with movements of patients within the hospital, also seem to have played a major role. These atypical colonization and transmission dynamics can help explain how the outbreak was maintained over the long term. This “stealthy” asymptomatic colonization of the gut, combined with heightened transmissibility (potentially reflecting a role for environmental reservoirs), means the dynamics of this outbreak share some properties with enteric pathogens such as vancomycin-resistant enterococci or Clostridium difficile.",
author = "Laurence Senn and Olivier Clerc and Giorgio Zanetti and Patrick Basset and Guy Prod'hom and Nicola Gordon and Anna Sheppard and Derrick Crook and Richard James and Thorpe, {Harry Arthur Frank Wright} and Edward Feil and Dominique Blanc",
year = "2016",
month = "1",
day = "19",
doi = "10.1128/mBio.02039-15",
language = "English",
volume = "7",
pages = "1--9",
journal = "mBio",
issn = "2161-2129",
publisher = "American Society for Microbiology",
number = "1",

}

TY - JOUR

T1 - The stealthy superbug

T2 - the role of asymptomatic enteric carriage in maintaining a long-term hospital outbreak of ST228 methicillin resistant Staphylococcus aureus

AU - Senn, Laurence

AU - Clerc, Olivier

AU - Zanetti, Giorgio

AU - Basset, Patrick

AU - Prod'hom, Guy

AU - Gordon, Nicola

AU - Sheppard, Anna

AU - Crook, Derrick

AU - James, Richard

AU - Thorpe, Harry Arthur Frank Wright

AU - Feil, Edward

AU - Blanc, Dominique

PY - 2016/1/19

Y1 - 2016/1/19

N2 - Whole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of ST228, rather than repeated introductions of this clone into the hospital. We note that this clone is significantly more frequently recovered from groin and rectal swabs than other clones (P < 0.0001) and is also significantly more transmissible between roommates (P < 0.01). Unrecognized MRSA carriers, together with movements of patients within the hospital, also seem to have played a major role. These atypical colonization and transmission dynamics can help explain how the outbreak was maintained over the long term. This “stealthy” asymptomatic colonization of the gut, combined with heightened transmissibility (potentially reflecting a role for environmental reservoirs), means the dynamics of this outbreak share some properties with enteric pathogens such as vancomycin-resistant enterococci or Clostridium difficile.

AB - Whole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of ST228, rather than repeated introductions of this clone into the hospital. We note that this clone is significantly more frequently recovered from groin and rectal swabs than other clones (P < 0.0001) and is also significantly more transmissible between roommates (P < 0.01). Unrecognized MRSA carriers, together with movements of patients within the hospital, also seem to have played a major role. These atypical colonization and transmission dynamics can help explain how the outbreak was maintained over the long term. This “stealthy” asymptomatic colonization of the gut, combined with heightened transmissibility (potentially reflecting a role for environmental reservoirs), means the dynamics of this outbreak share some properties with enteric pathogens such as vancomycin-resistant enterococci or Clostridium difficile.

U2 - 10.1128/mBio.02039-15

DO - 10.1128/mBio.02039-15

M3 - Article

VL - 7

SP - 1

EP - 9

JO - mBio

JF - mBio

SN - 2161-2129

IS - 1

M1 - e02039-15

ER -