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Transmission Clusters of Methicillin-Resistant Staphylococcus Aureus in Long-Term Care Facilities Based on Whole-Genome Sequencing

Published online by Cambridge University Press:  04 March 2016

O. Colin Stine ,
Shana Burrowes ,
Sophia David ,
J. Kristie Johnson  and
Mary-Claire Roghmann
O. Colin Stine
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, United States
Shana Burrowes
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, United States
Sophia David
Affiliation:
Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
J. Kristie Johnson
Affiliation:
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, United States
Mary-Claire Roghmann*
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, United States Geriatrics Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, Maryland, United States
*
Address correspondence to Mary-Claire Roghmann, MD, MS, University of Maryland School of Medicine, 10 South Pine Street, MTSF Room 336, Baltimore, MD 21201 ([email protected]).
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Abstract

OBJECTIVE

To define how often methicillin-resistant Staphylococcus aureus (MRSA) is spread from resident to resident in long-term care facilities using whole-genome sequencing

DESIGN

Prospective cohort study

SETTING

A long-term care facility

PARTICIPANTS

Elderly residents in a long-term care facility

METHODS

Cultures for MRSA were obtained weekly from multiple body sites from residents with known MRSA colonization over 12-week study periods. Simultaneously, cultures to detect MRSA acquisition were obtained weekly from 2 body sites in residents without known MRSA colonization. During the first 12-week cycle on a single unit, we sequenced 8 MRSA isolates per swab for 2 body sites from each of 6 residents. During the second 12-week cycle, we sequenced 30 MRSA isolates from 13 residents with known MRSA colonization and 3 residents who had acquired MRSA colonization.

RESULTS

MRSA isolates from the same swab showed little genetic variation between isolates with the exception of isolates from wounds. The genetic variation of isolates between body sites on an individual was greater than that within a single body site with the exception of 1 sample, which had 2 unrelated strains among the 8 isolates. In the second cycle, 10 of 16 residents colonized with MRSA (63%) shared 1 of 3 closely related strains. Of the 3 residents with newly acquired MRSA, 2 residents harbored isolates that were members of these clusters.

CONCLUSIONS

Point prevalence surveys with whole-genome sequencing of MRSA isolates may detect resident-to-resident transmission more accurately than routine surveillance cultures for MRSA in long-term care facilities.

Infect Control Hosp Epidemiol 2016;37:685–691

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Supplement 6 , June 2016 , pp. 685 - 691
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

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