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ABSTRACT: Background
Methicillin-resistant Staphylococcus aureus (MRSA) may cause prolonged outbreaks of infections in neonatal intensive care units (NICUs). While the specific factors favouring MRSA spread on neonatal wards are not well understood, colonized infants, their relatives, or health-care workers may all be sources for MRSA transmission. Whole-genome sequencing may provide a new tool for elucidating transmission pathways of MRSA at a local scale.Methods and findings
We applied whole-genome sequencing to trace MRSA spread in a NICU and performed a case-control study to identify risk factors for MRSA transmission. MRSA genomes had accumulated sequence variation sufficiently fast to reflect epidemiological linkage among individual patients, between infants and their mothers, and between infants and staff members, such that the relevance of individual nurses' nasal MRSA colonization for prolonged transmission could be evaluated. In addition to confirming previously reported risk factors, we identified an increased risk of transmission from infants with as yet unknown MRSA colonisation, in contrast to known MRSA-positive infants.Conclusions
The integration of epidemiological (temporal, spatial) and genomic data enabled the phylogenetic testing of several hypotheses on specific MRSA transmission routes within a neonatal intensive-care unit. The pronounced risk of transmission emanating from undetected MRSA carriers suggested that increasing the frequency or speed of microbiological diagnostics could help to reduce transmission of MRSA.
SUBMITTER: Nubel U
PROVIDER: S-EPMC3561456 | biostudies-literature | 2013
REPOSITORIES: biostudies-literature
Nübel Ulrich U Nachtnebel Matthias M Falkenhorst Gerhard G Benzler Justus J Hecht Jochen J Kube Michael M Bröcker Felix F Moelling Karin K Bührer Christoph C Gastmeier Petra P Piening Brar B Behnke Michael M Dehnert Manuel M Layer Franziska F Witte Wolfgang W Eckmanns Tim T
PloS one 20130131 1
<h4>Background</h4>Methicillin-resistant Staphylococcus aureus (MRSA) may cause prolonged outbreaks of infections in neonatal intensive care units (NICUs). While the specific factors favouring MRSA spread on neonatal wards are not well understood, colonized infants, their relatives, or health-care workers may all be sources for MRSA transmission. Whole-genome sequencing may provide a new tool for elucidating transmission pathways of MRSA at a local scale.<h4>Methods and findings</h4>We applied w ...[more]