ArticlePloS one2016
Genomic Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Strain Differences in Bloodstream and Skin Infection: Methicillin-ResistantOpen forum infectious diseases · 2024Article
- Low Viral Diversity Limits the Effectiveness of Sequence-Based Transmission Inference for SARS-CoV-2.mSphere · 2023Article
- Prevalence and epidemiological characteristics of methicillin-resistantAccess microbiology · 2023Article
- 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
- Methods Combining Genomic and Epidemiological Data in the Reconstruction of Transmission Trees: A Systematic Review.Pathogens (Basel, Switzerland) · 2022Review
- Genomic Epidemiology and Global Population Structure of Exfoliative Toxin A-ProducingFrontiers in microbiology · 2021Article
- Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network.Archives of disease in childhood · 2020Observational
- Beyond the SNP Threshold: Identifying Outbreak Clusters Using Inferred Transmissions.Molecular biology and evolution · 2019Article
- De Novo Mutations Resolve Disease Transmission Pathways in Clonal Malaria.Molecular biology and evolution · 2018Article
- A case of methicillin-resistantClinical case reports · 2018Article
- Draft Genome Sequence of Multidrug-Resistant Escherichia coli NIVEDI-P44, Isolated from a Chicken Fecal Sample in Northeast India.Genome announcements · 2018Article
- Infant Colonization With Methicillin-Resistant Staphylococcus aureus or Vancomycin-Resistant Enterococci Preceding Neonatal Intensive Care Unit Discharge.Journal of the Pediatric Infectious Diseases Society · 2017Article
- Multi-drug resistant Klebsiella pneumoniae strains circulating in hospital setting: whole-genome sequencing and Bayesian phylogenetic analysis for outbreak investigations.Scientific reports · 2017Article
- Phylodynamic applications in 21Global health research and policy · 2017Article
- Epidemiology of Methicillin-resistantJournal of global infectious diseasesArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Despite infection prevention efforts, neonatal intensive care unit (NICU) patients remain at risk of Methicillin-resistant Staphylococcus aureus (MRSA) infection. Modes of transmission for healthcare-associated (HA) and community-associated (CA) MRSA remain poorly understood and may vary by genotype, hindering the development of effective prevention and control strategies. From 2008-2010, all patients admitted to a level III NICU were screened for MRSA colonization, and all available isolates were spa-typed. Spa-type t008, the most prevalent CA- genotype in the United States, spa-type t045, a HA- related genotype, and a convenience sample of strains isolated from 2003-2011, underwent whole-genome sequencing and phylodynamic analysis. Patient risk factors were compared between colonized and noncolonized infants, and virulence and resistance genes compared between spa-type t008 and non-t008 strains. Epidemiological and genomic data were used to estimate MRSA importations and acquisitions through transmission reconstruction. MRSA colonization was identified in 9.1% (177/1940) of hospitalized infants and associated with low gestational age and birth weight. Among colonized infants, low gestational age was more common among those colonized with t008 strains. Our data suggest that approximately 70% of colonizations were the result of transmission events within the NICU, with the remainder likely to reflect importations of "outside" strains. While risk of transmission within the NICU was not affected by spa-type, patterns of acquisition and importation differed between t008 and t045 strains. Phylodynamic analysis showed the effective population size of spa-type t008 has been exponentially increasing in both community and hospital, with spa-type t008 strains possessed virulence genes not found among t045 strains; t045 strains, in contrast, appeared to be of more recent origin, with a possible hospital source. Our data highlight the importance of both intra-NICU transmission and recurrent introductions in maintenance of MRSA colonization within the NICU environment, as well as spa-type-specific differences in epidemiology.
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