Whole genome sequencing reveals two genetically distinct MRSA outbreaks among people who inject drugs and homeless people in Copenhagen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Dokumenter

  • Fulltext

    Forlagets udgivne version, 846 KB, PDF-dokument

Whole genome sequencing (WGS) has greatly improved the detection of methicillin-resistant Staphylococcus aureus (MRSA) transmission between people. We describe the transmission of two unique MRSA clones among homeless people in Copenhagen using WGS and core genome MLST (cgMLST). In 2014, an accumulation of MRSA bacteremia cases among homeless people admitted to our hospital was recognized, all having the rare MRSA spa t5147/ST88. The European Typology of Homelessness and Housing Exclusion (ETHOS) categories revealed that people who inject drugs (PWID) frequently visiting the milieu but living in private accommodation accounted for most cases. Hoping to terminate the transmission, 161 homeless people were MRSA screened in 2015, but no additional cases were found. From 2009 to 2018, 60 patients with genomically related t5147/ST88 isolates were found, of these 70% were confirmed to come from the homeless setting and 17% had bacteremia. From 2017 to 2020, cgMLST revealed a smaller MRSA outbreak including 13 PWID with a completely different clone, t1476/ST8, of which 15% had bacteremia. Our study confirms that WGS and cgMLST is excellent to reveal MRSA outbreaks. The ETHOS categorization can be useful to find the primary source of spread in the homeless community.
OriginalsprogEngelsk
TidsskriftAPMIS
Vol/bind131
Udgave nummer6
Sider (fra-til)294-302
Antal sider9
ISSN0903-4641
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
We are grateful for the help from the nurse staff at shelter clinics and the Men's Home street clinic ‘Sundhedsrummet’ at the Center for Marginalized Adults and Families, Copenhagen City Social Services who were in charge of MRSA screenings and ETHOS categorizations. We would also like to thank the WGS staff at DCM, Amager – and Hvidovre Hospital for excellent technical assistance. Finally, we would like to thank Barbro Mäkitalo, Public Health Agency of Sweden, for useful information about the Swedish t5147 case.

Publisher Copyright:
© 2023 The Authors. APMIS published by John Wiley & Sons Ltd on behalf of Scandinavian Societies for Pathology, Medical Microbiology and Immunology.

ID: 359854213