Waves of trouble: MRSA strain dynamics and assessment of the impact of infection control

Wyllie, David; Paul, John R.; Crook, Derrick W.

doi:10.1093/jac/dkr392

Cited by 53 publications

(51 citation statements)

References 34 publications

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“…CC239 was isolated frequently from respiratory tract specimens and patients with respiratory tract infections ( Table I) 10,13,[21][22][23] This study identified significant risk factors for CC22 relative to CC239, including older age, LTCF residence and admission to a subacute healthcare facility. In contrast, CC239 is primarily a nosocomial pathogen, with acquisition and transmission occurring within the acute care hospital system.…”

Section: Cc22 and Cc239 Have Different Epidemiological Nichesmentioning

confidence: 84%

Differing epidemiology of two major healthcare-associated meticillin-resistant Staphylococcus aureus clones

Jeremiah

Kandiah

Spelman

et al. 2016

Journal of Hospital Infection

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT

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Section: Cc22 and Cc239 Have Different Epidemiological Nichesmentioning

confidence: 84%

Differing epidemiology of two major healthcare-associated meticillin-resistant Staphylococcus aureus clones

Jeremiah

Kandiah

Spelman

et al. 2016

Journal of Hospital Infection

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“…However, surveillance data are rarely suitable to prove causal links. We cannot exclude other causes, such as changes in the frequency of testing and biological mechanisms [17]. For example with additional testing, which is likely to have occurred due to an increased awareness of the possibility of antibiotic resistance, the number of detected and reported cases is likely to increase [18].…”

Section: Discussionmentioning

confidence: 99%

Incidence of invasive meticillin-resistant Staphylococcus aureus infections in Germany, 2010 to 2014

et al. 2015

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Voluntary surveillance systems in Germany suggest a recent decline in the incidence of infections (subsequent to at least 2010) with meticillin-resistant Staphylococcus aureus (MRSA) from various types of specimens and settings. We asked whether this decline is reflected by data from the mandatory national surveillance system for invasive MRSA infections. Our analysis is based on the population in Germany in 2010 to 2014. Cases were identified from passive reporting by microbiological laboratories of the diagnosis of MRSA from blood culture or cerebrospinal fluid. Respective clinical data were subsequently added to the notification. We calculated risk ratios (RR) between consecutive years, stratifying cases by sex, age and federal state of residence. The national incidence increased from 4.6 episodes per 100,000 persons in 2010 to 5.6 in 2012 (2011 vs 2010: RR: 1.13, 95% confidence interval (CI): 1.08–1.18; 2012 vs 2011: RR: 1.08, 95% CI: 1.04–1.13). It stagnated at 5.4 per 100,000 in 2013 (RR: 0.97, 95% CI: 0.93–1.01) before declining to 4.8 in 2014 (RR: 0.88, 95% CI: 0.84–0.91). This trend was observed in most, but not all federal states and strata of sex and age groups. Only 204 of 20,679 (1%) episodes of infection were notified as belonging to an outbreak. Our analysis corroborates previous findings that the incidence of invasive MRSA infections in Germany may be declining.

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“…In the UK, healthcareassociated MRSA came to the fore in the 1990s mostly in the form of the two epidemic clones EMRSA-15 and EMRSA-16, the presence of which declined after 2005. 2 Genome sequence analysis to detect mecA enables the resistance phenotype to be predicted with high, although imperfect, accuracy. 3,4 The mecA gene is part of the SCCmec cassette that can be inserted into the staphylococcal chromosome and inherited vertically, or transferred between lineages via horizontal gene transfer.…”

Section: Introductionmentioning

confidence: 99%

Re-emergence of methicillin susceptibility in a resistant lineage ofStaphylococcus aureus

Ledda

Price

Cole

et al. 2017

J. Antimicrob. Chemother.

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Objectives: MRSA is a leading cause of hospital-associated infection. Acquired resistance is encoded by the mecA gene or its homologue mecC, but little is known about the evolutionary dynamics involved in gain and loss of resistance. The objective of this study was to obtain an expanded understanding of Staphylococcus aureus methicillin resistance microevolution in vivo, by focusing on a single lineage. Methods:We compared the whole-genome sequences of 231 isolates from a single epidemic lineage [clonal complex 30 (CC30) and spa-type t018] of S. aureus that caused an epidemic in the UK.Results: We show that resistance to methicillin in this single lineage was gained on at least two separate occasions, one of which led to a clonal expansion around 1995 presumably caused by a selective advantage. Resistance was, however, subsequently lost in vivo by nine strains isolated between 2008 and 2012. We describe the genetic mechanisms involved in this loss of resistance and the imperfect relationship between genotypic and phenotypic resistance. Conclusions:The recent re-emergence of methicillin susceptibility in this epidemic lineage suggests a significant fitness cost of resistance and reduced selective advantage following the introduction in the mid-2000s of MRSA hospital control measures throughout the UK.

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Waves of trouble: MRSA strain dynamics and assessment of the impact of infection control

Cited by 53 publications

References 34 publications

Differing epidemiology of two major healthcare-associated meticillin-resistant Staphylococcus aureus clones

Differing epidemiology of two major healthcare-associated meticillin-resistant Staphylococcus aureus clones

Incidence of invasive meticillin-resistant Staphylococcus aureus infections in Germany, 2010 to 2014

Re-emergence of methicillin susceptibility in a resistant lineage ofStaphylococcus aureus

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