A sporadic four-year hospital outbreak of a ST97-IVa MRSA with half of the patients first identified in the community
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A sporadic four-year hospital outbreak of a ST97-IVa MRSA with half of the patients first identified in the community. / Rubin, Ingrid M.; Hansen, Thomas A.; Klingenberg, Anne Mette; Petersen, Andreas M.; Worning, Peder; Westh, Henrik; Bartels, Mette D.
In: Frontiers in Microbiology, Vol. 9, 1494, 2018, p. 1-6.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - A sporadic four-year hospital outbreak of a ST97-IVa MRSA with half of the patients first identified in the community
AU - Rubin, Ingrid M.
AU - Hansen, Thomas A.
AU - Klingenberg, Anne Mette
AU - Petersen, Andreas M.
AU - Worning, Peder
AU - Westh, Henrik
AU - Bartels, Mette D.
PY - 2018
Y1 - 2018
N2 - This study describes a sporadically occurring 4-year outbreak of methicillin-resistant Staphylococcus aureus (MRSA) originating from a surgical ward. Whole-genome sequencing (WGS) identified the outbreak clone as spa type t267, sequence type ST97, and SCCmec IVa. Prompted by the finding of four patients within 6 months in the same ward with this unusual MRSA type, an outbreak was suspected. Subsequent MRSA screening in the ward in February 2017 identified three-additional patients and two health care workers (HCWs) with t267/ST97-IVa. WGS linked these 9 isolates to 16 previous isolates in our WGS database and the outbreak thus included 23 patients and two HCWs. Twenty-one patients had a connection to the surgery ward during the period 2013-2017, but half of them had MRSA diagnosed in the community long after discharge. The community debut of several patients MRSA infections weeks to months after hospital discharge made the identification of a hospital source difficult and it was the SNP relatedness of the isolates that led us to identify the common denominator of hospitalization. An index patient was not identified, but our hypothesis is that HCWs with unrecognized long-term MRSA colonization could have caused sporadic nosocomial transmission due to intermittent breaches in infection prevention and control practice.
AB - This study describes a sporadically occurring 4-year outbreak of methicillin-resistant Staphylococcus aureus (MRSA) originating from a surgical ward. Whole-genome sequencing (WGS) identified the outbreak clone as spa type t267, sequence type ST97, and SCCmec IVa. Prompted by the finding of four patients within 6 months in the same ward with this unusual MRSA type, an outbreak was suspected. Subsequent MRSA screening in the ward in February 2017 identified three-additional patients and two health care workers (HCWs) with t267/ST97-IVa. WGS linked these 9 isolates to 16 previous isolates in our WGS database and the outbreak thus included 23 patients and two HCWs. Twenty-one patients had a connection to the surgery ward during the period 2013-2017, but half of them had MRSA diagnosed in the community long after discharge. The community debut of several patients MRSA infections weeks to months after hospital discharge made the identification of a hospital source difficult and it was the SNP relatedness of the isolates that led us to identify the common denominator of hospitalization. An index patient was not identified, but our hypothesis is that HCWs with unrecognized long-term MRSA colonization could have caused sporadic nosocomial transmission due to intermittent breaches in infection prevention and control practice.
KW - CO-MRSA
KW - HCWs
KW - Outbreak
KW - ST97
KW - WGS
U2 - 10.3389/fmicb.2018.01494
DO - 10.3389/fmicb.2018.01494
M3 - Journal article
C2 - 30042745
AN - SCOPUS:85049839132
VL - 9
SP - 1
EP - 6
JO - Frontiers in Microbiology
JF - Frontiers in Microbiology
SN - 1664-302X
M1 - 1494
ER -
ID: 203883297