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Genotyping of Staphylococcus aureus by Ribosomal Spacer PCR RS-PCR
Published on: November 4, 2016
Core genome multi-locus sequence typing as an essential tool in a high-cost livestock-associated meticillin-resistant
M L Slott Jensen1, M Nielsine Skov1, H Pries Kristiansen1
1Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
Background:
Livestock-associated meticillin-resistant Staphylococcus aureus (LA-MRSA) clonal complex (CC) 398 may be transmitted and cause morbidity and mortality in hospitals. The economic cost of stopping hospital transmission of LA-MRSA CC398 is poorly described. Early detection of transmission may limit the extent of the intervention.
Aim:
To evaluate core genome multi-locus sequence typing (cgMLST) for detecting transmission chains and to estimate the costs for interventions to prevent further spread after discovery of hospital transmission of LA-MRSA CC398.
Methods:
Five patients were involved in two episodes of transmission of LA-MRSA CC398 in a hospital. Standard interventions including MRSA screening of patients and healthcare workers were initiated. Whole genome sequences of the five isolates and 17 epidemiologically unrelated MRSA CC398 isolates from other hospitalized patients were analysed by single nucleotide polymorphism (SNP) comparisons and cgMLST. The economic costs of constraining transmission were calculated from relevant sources.
Findings:
The five isolates suspected to be involved in hospital transmission clustered with ≤2 SNPs in the draft genome sequences with some distance to other isolates. cgMLST allocated the five isolates to the same type, which was different from all but two of the sporadic isolates. Furthermore, cgMLST separated the five transmission isolates from all other isolates. The economic costs of the outbreak interventions exceeded €11,000 per patient.
Conclusion:
LA-MRSA CC398 is transmittable in hospitals, and intervention against transmission may reach considerable costs. cgMLST is useful in surveillance of hospital transmission of LA-MRSA.
Insights
Livestock-associated meticillin-resistant Staphylococcus aureus (LA-MRSA) CC398 can spread in hospitals, costing over €11,000 per patient to control. Core genome multi-locus sequence typing (cgMLST) effectively detects these LA-MRSA transmission chains.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Livestock-associated meticillin-resistant Staphylococcus aureus (LA-MRSA) clonal complex (CC) 398 poses a risk for hospital transmission, potentially causing significant morbidity and mortality.
- The economic implications of controlling LA-MRSA CC398 hospital outbreaks are not well-documented, highlighting a need for efficient detection methods.
Purpose of the Study:
- To assess the utility of core genome multi-locus sequence typing (cgMLST) in identifying LA-MRSA CC398 transmission chains within a hospital setting.
- To estimate the financial costs associated with interventions aimed at preventing the further spread of LA-MRSA CC398 following its detection in hospitals.
Main Methods:
- Analysis of whole genome sequences from five LA-MRSA CC398 isolates involved in hospital transmission, alongside 17 unrelated isolates.
- Comparison of isolates using single nucleotide polymorphism (SNP) analysis and cgMLST to delineate transmission clusters.
- Calculation of economic costs based on implemented outbreak control measures.
Main Results:
- Whole genome sequencing revealed close clustering (≤2 SNPs) among the five suspected transmission isolates.
- cgMLST successfully identified the five transmission isolates as belonging to a single, distinct type, differentiating them from sporadic cases.
- Intervention costs for controlling the LA-MRSA CC398 outbreak exceeded €11,000 per patient.
Conclusions:
- LA-MRSA CC398 is capable of transmission within hospital environments, necessitating costly interventions.
- cgMLST is a valuable tool for surveillance and early detection of LA-MRSA hospital transmission events, aiding in timely control measures.
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