ArticlemBio2016
The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant Staphylococcus aureus.
Article in mBio, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.
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Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 147 citations in OpenAlex.
- Transmission routes of antibiotic resistant bacteria: a systematic review.BMC infectious diseases · 2022Pooled it
- Changes in anorectal and oropharyngeal microbiota following infection of Neisseria gonorrhoeae in men who have sex with men: a prospective cohort study.BMC microbiology · 2026Article
- Leveraging strain competition to address antimicrobial resistance with microbiota therapies.Gut microbes · 2025Review
- Multimodal analysis identifies microbiome changes linked to stem cell transplantation-associated diseases.Microbiome · 2024Article
- Genomic evolution of ST228 SCCmec-I MRSA 10 years after a major nosocomial outbreak.Journal of clinical microbiology · 2024Article
- Microbiota and metabolic adaptation shapebioRxiv : the preprint server for biology · 2024Article
- Bacterial Infections in Intensive Care Units: Epidemiological and Microbiological Aspects.Antibiotics (Basel, Switzerland) · 2024Review
- Biocontrol in built environments to reduce pathogen exposure and infection risk.The ISME journal · 2024Review
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- HIV, asymptomatic STI, and the rectal mucosal immune environment among young men who have sex with men.PLoS pathogens · 2023Article
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- Genetic characterization of Staphylococcus aureus isolated from Norway rats in Boston, Massachusetts.Veterinary medicine and science · 2023Article
- Staphylococcus aureus populations from the gut and the blood are not distinguished by virulence traits-a critical role of host barrier integrity.Microbiome · 2022Article
- Unsuspected Clonal Spread of Methicillin-Resistant Staphylococcus aureus Causing Bloodstream Infections in Hospitalized Adults Detected Using Whole Genome Sequencing.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection.BMC infectious diseases · 2022Article
- Staphylococcal trafficking and infection-from 'nose to gut' and back.FEMS microbiology reviews · 2022Review
- Efflux Pump Mediated Antimicrobial Resistance by Staphylococci in Health-Related Environments: Challenges and the Quest for Inhibition.Antibiotics (Basel, Switzerland) · 2021Review
- Pathogenicity and virulence ofVirulence · 2021Review
- Framing Bacterial Genomics for Public Health (Care).Journal of clinical microbiology · 2021Article
- Epidemiology of the Staphylococcus aureus CA-MRSA USA300 in Belgium.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Article
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12 authors at 3 institutions in 2 countries.
Funding
Abstract
unlabelledWhole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of ST228, rather than repeated introductions of this clone into the hospital. We note that this clone is significantly more frequently recovered from groin and rectal swabs than other clones (P < 0.0001) and is also significantly more transmissible between roommates (P < 0.01). Unrecognized MRSA carriers, together with movements of patients within the hospital, also seem to have played a major role. These atypical colonization and transmission dynamics can help explain how the outbreak was maintained over the long term. This "stealthy" asymptomatic colonization of the gut, combined with heightened transmissibility (potentially reflecting a role for environmental reservoirs), means the dynamics of this outbreak share some properties with enteric pathogens such as vancomycin-resistant enterococci or Clostridium difficile. IMPORTANCE: Using whole-genome sequencing, we showed that a large and prolonged outbreak of methicillin-resistant Staphylococcus aureus was due to the clonal spread of a specific strain with genetic elements adapted to the hospital environment. Unrecognized MRSA carriers, the movement of patients within the hospital, and the low detection with clinical specimens were also factors that played a role in this occurrence. The atypical colonization of the gut means the dynamics of this outbreak may share some properties with enteric pathogens.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.