ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
MRSA Transmission Dynamics Among Interconnected Acute, Intermediate-Term, and Long-Term Healthcare Facilities in Singapore.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Whole-genome sequencing to explore genomic profile, pathogenicity, virulence motifs, and pangenome of clinical MRSA isolates.Scientific reports · 2025Article
- Genomic Analysis of MRSA for Evaluating Local Transmission Dynamics in Geriatric Long-Term Care Facilities in Japan.Antibiotics (Basel, Switzerland) · 2025Article
- Genomic evaluation of phenotypic antibiotic susceptibility patterns as a surrogate for MRSA relatedness and putative transmission during outbreak investigations.Infection prevention in practice · 2025Article
- The mutational landscape of Staphylococcus aureus during colonisation.Nature communications · 2025Article
- The attributable mortality, length of stay, and health care costs of methicillin-resistantIJID regions · 2024Article
- Whole genome sequencing of methicillin-resistant Staphylococcus aureus clinical isolates from Terengganu, Malaysia, indicates the predominance of the EMRSA-15 (ST22-SCCmec IV) clone.Scientific reports · 2024Article
- Novel multidrug-resistant sublineages ofmSphere · 2023Article
- Prevalence of Antibiotic-Resistant Pathogenic Bacteria and Level of Antibiotic Residues in Hospital Effluents in Selangor, Malaysia: Protocol for a Cross-sectional Study.JMIR research protocols · 2023Article
- Diversity and Dissemination of Methicillin-ResistantTropical medicine and infectious disease · 2022Review
- Beyond CC398: Characterisation of Other Tetracycline and Methicillin-ResistantPathogens (Basel, Switzerland) · 2022Article
- Detection, spread and phylogeny of meticillin-resistantMicrobial genomics · 2021Article
- Article
- Combating Antimicrobial Resistance in Singapore: A Qualitative Study Exploring the Policy Context, Challenges, Facilitators, and Proposed Strategies.Antibiotics (Basel, Switzerland) · 2019Article
- Genome Mining and Comparative Pathogenomic Analysis of An Endemic Methicillin-ResistantPathogens (Basel, Switzerland) · 2019Article
- Status and potential of bacterial genomics for public health practice: a scoping review.Implementation science : IS · 2019Article
- Ten-year narrative review on antimicrobial resistance in Singapore.Singapore medical journal · 2019Review
- Intranasal octenidine and universal antiseptic bathing reduce methicillin-resistant Staphylococcus aureus (MRSA) prevalence in extended care facilities.Epidemiology and infection · 2018Article
- Methicillin-resistant Staphylococcus aureus colonisation: epidemiological and molecular characteristics in an acute-care tertiary hospital in Singapore.Epidemiology and infection · 2018Article
- Real-Life Evidence for Tedizolid Phosphate in the Treatment of Cellulitis and Wound Infections: A Case Series.Infectious diseases and therapy · 2018Article
- Cross-transmission in the Dental Office: Does This Make You Ill?Current oral health reports · 2018Review
Corrections and comments
- Erratum issuedErratum.2017
Authors and funding
16 authors.
Funding
Abstract
backgroundMethicillin-resistant Staphylococcus aureus (MRSA) is the most common healthcare-associated multidrug-resistant organism. Despite the interconnectedness between acute care hospitals (ACHs) and intermediate- and long-term care facilities (ILTCFs), the transmission dynamics of MRSA between healthcare settings is not well understood.
methodsWe conducted a cross-sectional study in a network comprising an ACH and 5 closely affiliated ILTCFs in Singapore. A total of 1700 inpatients were screened for MRSA over a 6-week period in 2014. MRSA isolates underwent whole-genome sequencing, with a pairwise single-nucleotide polymorphism (Hamming distance) cutoff of 60 core genome single-nucleotide polymorphisms used to define recent transmission clusters (clades) for the 3 major clones.
resultsMRSA prevalence was significantly higher in intermediate-term (29.9%) and long-term (20.4%) care facilities than in the ACH (11.8%) (P < .001). The predominant clones were sequence type [ST] 22 (n = 183; 47.8%), ST45 (n = 129; 33.7%), and ST239 (n = 26; 6.8%), with greater diversity of STs in ILTCFs relative to the ACH. A large proportion of the clades in ST22 (14 of 21 clades; 67%) and ST45 (7 of 13; 54%) included inpatients from the ACH and ILTCFs. The most frequent source of the interfacility transmissions was the ACH (n = 28 transmission events; 36.4%).
conclusionsMRSA transmission dynamics between the ACH and ILTCFs were complex. The greater diversity of STs in ILTCFs suggests that the ecosystem in such settings might be more conducive for intrafacility transmission events. ST22 and ST45 have successfully established themselves in ILTCFs. The importance of interconnected infection prevention and control measures and strategies cannot be overemphasized.
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