Back to Search
Start Over
A Complete Genome Screening Program of Clinical Methicillin-Resistant Staphylococcus aureus Isolates Identifies the Origin and Progression of a Neonatal Intensive Care Unit Outbreak
- Source :
- Journal of Clinical Microbiology
- Publication Year :
- 2019
- Publisher :
- American Society for Microbiology, 2019.
-
Abstract
- Whole-genome sequencing (WGS) of Staphylococcus aureus is increasingly used as part of infection prevention practices. In this study, we established a long-read technology-based WGS screening program of all first-episode methicillin-resistant Staphylococcus aureus (MRSA) blood infections at a major urban hospital.<br />Whole-genome sequencing (WGS) of Staphylococcus aureus is increasingly used as part of infection prevention practices. In this study, we established a long-read technology-based WGS screening program of all first-episode methicillin-resistant Staphylococcus aureus (MRSA) blood infections at a major urban hospital. A survey of 132 MRSA genomes assembled from long reads enabled detailed characterization of an outbreak lasting several months of a CC5/ST105/USA100 clone among 18 infants in a neonatal intensive care unit (NICU). Available hospital-wide genome surveillance data traced the origins of the outbreak to three patients admitted to adult wards during a 4-month period preceding the NICU outbreak. The pattern of changes among complete outbreak genomes provided full spatiotemporal resolution of its progression, which was characterized by multiple subtransmissions and likely precipitated by equipment sharing between adults and infants. Compared to other hospital strains, the outbreak strain carried distinct mutations and accessory genetic elements that impacted genes with roles in metabolism, resistance, and persistence. This included a DNA recognition domain recombination in the hsdS gene of a type I restriction modification system that altered DNA methylation. Transcriptome sequencing (RNA-Seq) profiling showed that the (epi)genetic changes in the outbreak clone attenuated agr gene expression and upregulated genes involved in stress response and biofilm formation. Overall, our findings demonstrate the utility of long-read sequencing for hospital surveillance and for characterizing accessory genomic elements that may impact MRSA virulence and persistence.
- Subjects :
- Adult
Methicillin-Resistant Staphylococcus aureus
0301 basic medicine
Microbiology (medical)
Neonatal intensive care unit
Genotype
Epidemiology
030106 microbiology
Virulence
Bacteremia
MRSA
Biology
medicine.disease_cause
Genome
Disease Outbreaks
03 medical and health sciences
Intensive Care Units, Neonatal
Disease Transmission, Infectious
medicine
Humans
Mass Screening
Gene
NICU outbreak
genome analysis
Cross Infection
Molecular Epidemiology
Whole Genome Sequencing
Infant, Newborn
Infant
Outbreak
Staphylococcal Infections
Virology
Methicillin-resistant Staphylococcus aureus
Hospitals
3. Good health
030104 developmental biology
Staphylococcus aureus
DNA methylation
Subjects
Details
- ISSN :
- 1098660X and 00951137
- Volume :
- 57
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Microbiology
- Accession number :
- edsair.doi.dedup.....a687c904c52ebc81dc02710f81ad675d