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Updated: Nov 2, 2025
Methodology for the Study of Horizontal Gene Transfer in Staphylococcus aureus
Published on: March 10, 2017
Household Transmission of Community-Associated Methicillin-Resistant Staphylococcus Aureus
Feiteng Zhu1,2, Hemu Zhuang1,2, Shujuan Ji1,2
1Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
Abstract:
Currently, the mechanism of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) transmission mechanism is unclear; however, it must be considered in conjunction with asymptomatic S. aureus strains colonization dynamics. This epidemiological study aimed to determine the role of the household in CA-MRSA transmission in China. Five patients with culture-confirmed CA-MRSA infection and five control patients were recruited from the Sir Run Run Shaw Hospital in Zhejiang, China, between December 2019 and January 2020. The household members of the patients, their pets, and environmental surfaces were sampled and screened for MRSA colonization. Mass spectrometry identification and antimicrobial susceptibility testing were performed on the MRSA isolates. Whole-genome sequencing and core genome multilocus sequence typing (cgMLST) were performed to determine the origin and transmission of the MRSA isolates in the households. Overall, 14 S. aureus-positive specimens (14.1%, 14/99) were obtained from the five households of patients with CA-MRSA infections, of which 12 (85.7%) were MRSA. The overall positivity of MRSA was 12.1% (12/99) among the samples from the CA-MRSA households, while no MRSA isolates were detected in the five control households. Most MRSA isolates belonged to epidemic CA-MRSA clones, such as ST59 (15/35, 42.9%) and ST508 (15/35, 42.9%). The cgMLST results confirmed that MRSA was transmitted among patients, contacts, and pets in the households and was present on environmental surfaces in the CA-MRSA patients' households. In conclusion, the study revealed that the home environment was an important MRSA reservoir. Therefore, focusing on MRSA decolonization in patients alone is not sufficient for infection control of CA-MRSA.
Insights
The home environment acts as a significant reservoir for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) transmission. Household contacts, pets, and surfaces can harbor and spread CA-MRSA, necessitating broader infection control strategies beyond individual patient decolonization.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Background:
- The transmission dynamics of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) remain incompletely understood.
- Asymptomatic colonization by Staphylococcus aureus strains plays a crucial role in CA-MRSA epidemiology.
- Understanding the role of the household environment is critical for effective CA-MRSA control.
Purpose of the Study:
- To investigate the role of the household environment in the transmission of CA-MRSA in China.
- To identify the sources and transmission pathways of CA-MRSA within households.
- To evaluate the prevalence of MRSA colonization among household members, pets, and environmental surfaces.
Main Methods:
- Epidemiological study involving five CA-MRSA infected patients and five control patients.
- Sampling of household members, pets, and environmental surfaces for MRSA colonization.
- Mass spectrometry, antimicrobial susceptibility testing, whole-genome sequencing, and core genome multilocus sequence typing (cgMLST) for isolate characterization and transmission analysis.
Main Results:
- MRSA was detected in 12.1% of samples from CA-MRSA patient households, with no MRSA found in control households.
- Epidemic CA-MRSA clones, including ST59 and ST508, were prevalent.
- cgMLST confirmed MRSA transmission among household contacts, pets, and environmental surfaces.
Conclusions:
- The home environment serves as a significant reservoir for CA-MRSA.
- MRSA transmission occurs between patients, contacts, pets, and surfaces within households.
- Infection control strategies must extend beyond individual patient decolonization to include environmental and contact management.
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