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MRSA transmission on a neonatal intensive care unit: epidemiological and genome-based phylogenetic analyses.
MedLine Citation:
PMID:  23382995     Owner:  NLM     Status:  In-Data-Review    
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.
Ulrich Nübel; Matthias Nachtnebel; Gerhard Falkenhorst; Justus Benzler; Jochen Hecht; Michael Kube; Felix Bröcker; Karin Moelling; Christoph Bührer; Petra Gastmeier; Brar Piening; Michael Behnke; Manuel Dehnert; Franziska Layer; Wolfgang Witte; Tim Eckmanns
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Publication Detail:
Type:  Journal Article     Date:  2013-01-31
Journal Detail:
Title:  PloS one     Volume:  8     ISSN:  1932-6203     ISO Abbreviation:  PLoS ONE     Publication Date:  2013  
Date Detail:
Created Date:  2013-02-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101285081     Medline TA:  PLoS One     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e54898     Citation Subset:  IM    
Department of Infectious Diseases, Unit of Nosocomial Infections, Robert Koch Institute, Wernigerode, Germany.
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