Observational studyThe Lancet. Microbe2020
Definition of a genetic relatedness cutoff to exclude recent transmission of meticillin-resistant
Observational study in The Lancet. Microbe, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers.
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Who cites it
87 citing papers in PubMed.
- Fecal microbiota transplantation promotes reduction of antimicrobial resistance by strain replacement.Science translational medicine · 2023Trial
- Sampling and Host-Strain Interactions Shape Detection of Staphylococcus aureus Transmission in Hospitals.The Journal of infectious diseases · 2026Article
- Phylogeographic analysis of Staphylococcus nepalensis reveals global occurrence of antimicrobial-resistant lineages carrying the sal(E) resistance gene.Molecular biology reports · 2026Article
- Wildlife as a reservoir of OXA-48-like carbapenemase-producing Enterobacterales.Microbiology spectrum · 2026Article
- Plasmids of co-circulating Staphylococcus aureus serve as vehicles for antimicrobial resistance sharing across diseased host-species at short timescales.BMC microbiology · 2026Article
- Genetic determinants of Staphylococcus aureus adhesion shape virulence trade-offs in bacteremia.Nature communications · 2026Article
- Evaluating the performance of Fourier transform infrared spectroscopy for typing and outbreak investigation of methicillin-resistant and -susceptibleMicrobiology spectrum · 2026Article
- Genetic diversity and drug resistance profiles ofMicrobiology spectrum · 2026Article
- Genome sequencing for prevention of health-care-associated bacterial infections.Nature reviews. Microbiology · 2026Review
- Genetic diversity and within-farm transmission of Staphylococcus aureus from ewes in Norway.BMC microbiology · 2026Article
- Evolutionary and Mobile Genetic Element Analysis of a Multidrug-Resistant ST398-MRSA-Vc Isolate from Ready-to-Eat Pork Products.Antibiotics (Basel, Switzerland) · 2026Article
- Comparing Clinical, Microbiological, and Genetic Definitions of Relapse in Patients With Subsequent Episodes of Methicillin-resistant Staphylococcus aureus Bone and Joint Infection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Global in silico genomic epidemiology of tetracycline resistance in Staphylococcus aureus: one health dynamics and genotype-phenotype associations.Molecular genetics and genomics : MGG · 2026Article
- Prediction of genetic relatedness ofAntimicrobial agents and chemotherapy · 2026Article
- Genomic and epidemiological identification of Pseudomonas aeruginosa transmission chains and in hospital ICUs.Genome biology · 2026Article
- CRISPR-Cas-associated SCCmec Variants in Methicillin-resistant Staphylococcus aureus Evade Rapid Diagnostic Detection.The Journal of infectious diseases · 2026Article
- Global emergence and evolution ofmSystems · 2026Article
- Rapid dissemination of Staphylococcus aureus in the neonatal intensive care unit is associated with invasive infection.Nature communications · 2026Article
- MRSA in Tibet: high prevalence driven by the epidemic clone CC59-ST59-SCCFrontiers in microbiology · 2026Article
- Enhanced Spread of Carbapenem-ResistantInfection and drug resistance · 2026Article
27 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors.
Funding
Abstract
backgroundWhole-genome sequencing (WGS) can be used in genomic epidemiology investigations to confirm or refute outbreaks of bacterial pathogens, and to support targeted and efficient infection control interventions. We aimed to define a genetic relatedness cutoff, quantified as a number of single-nucleotide polymorphisms (SNP), for meticillin-resistant
methodsWe did a retrospective genomic and epidemiological analysis of MRSA data from two prospective observational cohort studies in the UK to establish SNP cutoffs for genetic relatedness, above which recent transmission was unlikely. We used three separate approaches to calculate these thresholds. First, we applied a linear mixed model to estimate the
findingsIn the linear mixed model, the estimated substitution rate was roughly 5 whole-genome SNPs (wgSNPs) or 3 core-genome SNPs (cgSNPs) per genome per year, and the 95th percentile within-host diversity was 19 wgSNPs or 10 cgSNPs. The combined SNP cutoffs for detection of MRSA transmission within 6 months per this model were thus 24 wgSNPs or 13 cgSNPs. The simulated transmission model suggested that cutoffs of 17 wgSNPs or 12 cgSNPs would detect 95% of MRSA transmission events within the same timeframe. Finally, in the second cohort, cutoffs of 22 wgSNPs or 11 cgSNPs captured 95% of epidemiologically linked cases within 6 months.
interpretationOn the basis of our results, we propose conservative cutoffs of 25 wgSNPs or 15 cgSNPS above which transmission of MRSA within the previous 6 months can be ruled out. These cutoffs could potentially be used as part of a genomic sequencing approach to the management of outbreaks of MRSA in conjunction with traditional epidemiological techniques.
fundingUK Department of Health, Wellcome Trust, UK National Institute for Health Research.
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