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Investigation of classical epidemiological links between patients harbouring identical, non-predominant meticillin-resistant Staphylococcus aureus genotypes and lessons for epidemiological tracking.
- Source :
-
The Journal of hospital infection [J Hosp Infect] 2011 Nov; Vol. 79 (3), pp. 202-5. Date of Electronic Publication: 2011 Jul 07. - Publication Year :
- 2011
-
Abstract
- According to molecular epidemiology theory, two isolates belong to the same chain of transmission if they are similar according to a highly discriminatory molecular typing method. This has been demonstrated in outbreaks, but is rarely studied in endemic situations. Person-to-person transmission cannot be established when isolates of meticillin-resistant Staphylococcus aureus (MRSA) belong to endemically predominant genotypes. By contrast, isolates of infrequent genotypes might be more suitable for epidemiological tracking. The objective of the present study was to determine, in newly identified patients harbouring non-predominant MRSA genotypes, whether putative epidemiological links inferred from molecular typing could replace classical epidemiology in the context of a regional surveillance programme. MRSA genotypes were defined using double-locus sequence typing (DLST) combining clfB and spa genes. A total of 1,268 non-repetitive MRSA isolates recovered between 2005 and 2006 in Western Switzerland were typed: 897 isolates (71%) belonged to four predominant genotypes, 231 (18%) to 55 non-predominant genotypes, and 140 (11%) were unique. Obvious epidemiological links were found in only 106/231 (46%) patients carrying isolates with non-predominant genotypes suggesting that molecular surveillance identified twice as many clusters as those that may have been suspected with classical epidemiological links. However, not all of these molecular clusters represented person-to-person transmission. Thus, molecular typing cannot replace classical epidemiology but is complementary. A prospective surveillance of MRSA genotypes could help to target epidemiological tracking in order to recognise new risk factors in hospital and community settings, or emergence of new epidemic clones.<br /> (Copyright © 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Bacterial Proteins genetics
Bacterial Typing Techniques
Carrier State microbiology
Carrier State transmission
Child
Child, Preschool
Cluster Analysis
Community-Acquired Infections microbiology
Community-Acquired Infections transmission
Cross Infection microbiology
Cross Infection transmission
DNA, Bacterial genetics
Genotype
Humans
Infant
Methicillin-Resistant Staphylococcus aureus classification
Methicillin-Resistant Staphylococcus aureus isolation & purification
Molecular Epidemiology
Prospective Studies
Sequence Analysis, DNA methods
Staphylococcal Infections microbiology
Staphylococcal Infections transmission
Switzerland epidemiology
Young Adult
Carrier State epidemiology
Community-Acquired Infections epidemiology
Cross Infection epidemiology
Methicillin-Resistant Staphylococcus aureus genetics
Population Surveillance methods
Staphylococcal Infections epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2939
- Volume :
- 79
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The Journal of hospital infection
- Publication Type :
- Academic Journal
- Accession number :
- 21741113
- Full Text :
- https://doi.org/10.1016/j.jhin.2011.04.021