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Abstract

Background

Mandatory reporting of methicillin-resistant (MRSA) bloodstream infections (BSI) has occurred in England for over 15years. Epidemiological information is recorded, but routine collection of isolates for characterisation has not been routinely undertaken. Ongoing developments in whole-genome sequencing (WGS) have demonstrated its value in outbreak investigations and for determining the spread of antimicrobial resistance and bacterial population structure. Benefits of adding genomics to routine epidemiological MRSA surveillance are unknown.

Aim

To determine feasibility and potential utility of adding genomics to epidemiological surveillance of MRSA.

Methods

We conducted an epidemiological and genomic survey of MRSA BSI in England over a 1-year period (1 October 2012­–30 September 2013).

Results

During the study period, 903 cases of MRSA BSI were reported; 425 isolates were available for sequencing of which, 276 (65%) were clonal complex (CC) 22. Addition of 64 MRSA genomes from published outbreak investigations showed that the study genomes could provide context for outbreak isolates and supported cluster identification. Comparison to other MRSA genome collections demonstrated variation in clonal diversity achieved through different sampling strategies and identified potentially high-risk clones e.g. USA300 and local expansion of CC5 MRSA in South West England.

Conclusions

We demonstrate the potential utility of combined epidemiological and genomic MRSA BSI surveillance to determine the national population structure of MRSA, contextualise previous MRSA outbreaks, and detect potentially high-risk lineages. These findings support the integration of epidemiological and genomic surveillance for MRSA BSI as a step towards a comprehensive surveillance programme in England.

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2019-01-24
2024-12-03
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.4.1800215
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Prospective genomic surveillance of methicillin-resistant Staphylococcus aureus (MRSA) associated with bloodstream infection, England, 1 October 2012 to 30 September 2013
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Michelle+S+Toleman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Toleman Michelle S</a>, <a href="/search?value1=Sandra+Reuter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reuter Sandra</a>, <a href="/search?value1=Dorota+Jamrozy&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jamrozy Dorota</a>, <a href="/search?value1=Hayley+J+Wilson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wilson Hayley J</a>, <a href="/search?value1=Beth+Blane&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Blane Beth</a>, <a href="/search?value1=Ewan+M+Harrison&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Harrison Ewan M</a>, <a href="/search?value1=Francesc+Coll&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Coll Francesc</a>, <a href="/search?value1=Russell+J+Hope&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hope Russell J</a>, <a href="/search?value1=Angela+Kearns&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kearns Angela</a>, <a href="/search?value1=Julian+Parkhill&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Parkhill Julian</a>, <a href="/search?value1=Sharon+J+Peacock&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Peacock Sharon J</a>, <a href="/search?value1=M+Est%C3%A9e+T%C3%B6r%C3%B6k&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Török M Estée</a></span>. Prospective genomic surveillance of methicillin-resistant Staphylococcus aureus (MRSA) associated with bloodstream infection, England, 1 October 2012 to 30 September 2013. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(4):pii=1800215. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.4.1800215" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.4.1800215</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 25 Apr 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 01 Oct 2018 </span> </p>
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