PMID- 30022976
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1664-302X (Print)
IS  - 1664-302X (Electronic)
IS  - 1664-302X (Linking)
VI  - 9
DP  - 2018
TI  - Intra-Hospital, Inter-Hospital and Intercontinental Spread of ST78 MRSA From Two 
      Neonatal Intensive Care Unit Outbreaks Established Using Whole-Genome Sequencing.
PG  - 1485
LID - 10.3389/fmicb.2018.01485 [doi]
LID - 1485
AB  - From 2009 to 2011 [transmission period (TP) 1] and 2014 to 2017 (TP2), two 
      outbreaks involving community-associated clonal complex (CC) 88-MRSA spa types 
      t186 and t786, respectively, occurred in the Neonatal Intensive Care Unit (NICU) 
      of an Irish hospital (H1). This study investigated the relatedness of these 
      isolates, their relationship to other CC88 MRSA from Ireland and their likely 
      geographic origin, using whole-genome sequencing (WGS). All 28 CC88-MRSA isolates 
      identified at the Irish National MRSA Reference Laboratory between 2009 and 2017 
      were investigated including 20 H1 patient isolates, two H1 isolates recovered 
      from a single healthcare worker (HCW) 2 years apart, three patient isolates from 
      a second hospital (H2) and one patient isolate from each of three different 
      hospitals (H3, H4, and H5). All isolates underwent DNA microarray profiling. 
      Thirteen international isolates with similar microarray profiles to at least one 
      Irish isolate were selected from an extensive global database. All isolates 
      underwent Illumina MiSeq WGS. The majority of Irish isolates (25/28; all H1 
      isolates, two H2 isolates and the H3 isolate) were identified as ST78-MRSA-IVa 
      and formed a large cluster, exhibiting 1-71 pairwise allelic differences, in a 
      whole-genome MLST-based minimum spanning tree (MST) involving all Irish isolates. 
      A H1/H2, H1/H3, and H1 HCW/patient isolate pair each exhibited one allelic 
      difference. The TP2 isolates were characterised by a different spa type and the 
      loss of hsdS. The three remaining Irish isolates (from H2, H4, and H5) were 
      identified as ST88-MRSA-IVa and dispersed at the opposite end of the MST, 
      exhibiting 81-211 pairwise allelic differences. Core-genome MLST and 
      sequence-based plasmid analysis revealed the recent shared ancestry of Irish and 
      Australian ST78-MRSA-IVa, and of Irish and French/Egyptian ST88-MRSA-IVa. This 
      study revealed the homogeneity of isolates recovered during two NICU outbreaks 
      (despite spa type and hsdS carriage variances), HCW involvement in the outbreak 
      transmission chain and the strain's spread to two other Irish hospitals. The 
      outbreak strain, CC88/ST78-MRSA-IVa, was likely imported from Australia, where it 
      is prevalent. CC88/ST88-MRSA-IVa was also identified in Irish hospitals and was 
      likely imported from Africa, where it is predominant, and/or a country with a 
      large population of African descent.
FAU - Earls, Megan R
AU  - Earls MR
AD  - Microbiology Research Unit, Dublin Dental University Hospital, Trinity College, 
      University of Dublin, Dublin, Ireland.
FAU - Coleman, David C
AU  - Coleman DC
AD  - Microbiology Research Unit, Dublin Dental University Hospital, Trinity College, 
      University of Dublin, Dublin, Ireland.
FAU - Brennan, Grainne I
AU  - Brennan GI
AD  - National MRSA Reference Laboratory, St. James's Hospital, Dublin, Ireland.
FAU - Fleming, Tanya
AU  - Fleming T
AD  - National MRSA Reference Laboratory, St. James's Hospital, Dublin, Ireland.
FAU - Monecke, Stefan
AU  - Monecke S
AD  - Abbott (Alere Technologies GmbH), Jena, Germany.
AD  - InfectGnostics Research Campus, Jena, Germany.
FAU - Slickers, Peter
AU  - Slickers P
AD  - Abbott (Alere Technologies GmbH), Jena, Germany.
AD  - InfectGnostics Research Campus, Jena, Germany.
FAU - Ehricht, Ralf
AU  - Ehricht R
AD  - Abbott (Alere Technologies GmbH), Jena, Germany.
AD  - InfectGnostics Research Campus, Jena, Germany.
FAU - Shore, Anna C
AU  - Shore AC
AD  - Microbiology Research Unit, Dublin Dental University Hospital, Trinity College, 
      University of Dublin, Dublin, Ireland.
LA  - eng
PT  - Journal Article
DEP - 20180704
PL  - Switzerland
TA  - Front Microbiol
JT  - Frontiers in microbiology
JID - 101548977
PMC - PMC6039561
OTO - NOTNLM
OT  - NICU outbreak
OT  - ST78-MRSA-IVa
OT  - ST88-MRSA-IVa
OT  - community-associated MRSA
OT  - core-genome MLST
OT  - sequence-based plasmid analysis
OT  - whole-genome MLST
OT  - whole-genome sequencing
EDAT- 2018/07/20 06:00
MHDA- 2018/07/20 06:01
PMCR- 2018/07/04
CRDT- 2018/07/20 06:00
PHST- 2018/04/13 00:00 [received]
PHST- 2018/06/14 00:00 [accepted]
PHST- 2018/07/20 06:00 [entrez]
PHST- 2018/07/20 06:00 [pubmed]
PHST- 2018/07/20 06:01 [medline]
PHST- 2018/07/04 00:00 [pmc-release]
AID - 10.3389/fmicb.2018.01485 [doi]
PST - epublish
SO  - Front Microbiol. 2018 Jul 4;9:1485. doi: 10.3389/fmicb.2018.01485. eCollection 
      2018.