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dc.contributor.authorCreamer, E
dc.contributor.authorShore, A C
dc.contributor.authorRossney, A S
dc.contributor.authorDolan, A
dc.contributor.authorSherlock, O
dc.contributor.authorFitzgerald-Hughes, D
dc.contributor.authorSullivan, D J
dc.contributor.authorKinnevey, P M
dc.contributor.authorO'Lorcain, P
dc.contributor.authorCunney, R
dc.contributor.authorColeman, D C
dc.contributor.authorHumphreys, H
dc.date.accessioned2013-05-21T13:23:31Z
dc.date.available2013-05-21T13:23:31Z
dc.date.issued2012-11
dc.identifier.citationTransmission of endemic ST22-MRSA-IV on four acute hospital wards investigated using a combination of spa, dru and pulsed-field gel electrophoresis typing. 2012, 31 (11):3151-61 Eur. J. Clin. Microbiol. Infect. Dis.en_GB
dc.identifier.issn1435-4373
dc.identifier.pmid22814876
dc.identifier.doi10.1007/s10096-012-1678-7
dc.identifier.urihttp://hdl.handle.net/10147/292550
dc.description.abstractThe transmission of meticillin-resistant Staphylococcus aureus (MRSA) between individual patients is difficult to track in institutions where MRSA is endemic. We investigated the transmission of MRSA where ST22-MRSA-IV is endemic on four wards using demographic data, patient and environmental screening, and molecular typing of isolates. A total of 939 patients were screened, 636 within 72 h of admission (on admission) and 303 >72 h after admission, and 1,252 environmental samples were obtained. Isolates were typed by spa, dru and pulsed-field gel electrophoresis (PFGE) typing. A composite dendrogram generated from the three sets of typing data was used to divide isolates into 'dendrogram groups' (DGs). Ten percent of patients (92/939) were MRSA-positive; 7 % (44/636) on admission and 16 % (48/303) >72 h after admission (p = 0.0007). MRSA was recovered from 5 % of environmental specimens (65/1,252). Most isolates from patients (97 %, 85/88) and the environment (97 %, 63/65) exhibited the ST22-MRSA-IV genotype. Four DGs (DG1, DG4, DG16 and DG17) accounted for 58 % of ST22-MRSA-IV isolates from patients. Epidemiological evidence suggested cross-transmission among 44/92 patients (48 %) but molecular typing confirmed probable cross-transmission in only 11 instances (13 %, 11/88), with the majority of cross-transmission (64 %; 7/11) occurring on one ward. In the setting of highly clonal endemic MRSA, the combination of local epidemiology, PFGE, spa and dru typing provided valuable insights into MRSA transmission.
dc.language.isoenen
dc.publisherEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiologyen_GB
dc.rightsArchived with thanks to European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiologyen_GB
dc.subject.meshBacterial Proteins
dc.subject.meshCluster Analysis
dc.subject.meshCross Infection
dc.subject.meshElectrophoresis, Gel, Pulsed-Field
dc.subject.meshEnvironmental Microbiology
dc.subject.meshHospitals
dc.subject.meshHumans
dc.subject.meshMethicillin-Resistant Staphylococcus aureus
dc.subject.meshMolecular Epidemiology
dc.subject.meshMolecular Typing
dc.subject.meshProspective Studies
dc.subject.meshStaphylococcal Infections
dc.titleTransmission of endemic ST22-MRSA-IV on four acute hospital wards investigated using a combination of spa, dru and pulsed-field gel electrophoresis typing.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Clinical Microbiology, Education and Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.en_GB
dc.identifier.journalEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiologyen_GB
dc.description.provinceLeinsteren
html.description.abstractThe transmission of meticillin-resistant Staphylococcus aureus (MRSA) between individual patients is difficult to track in institutions where MRSA is endemic. We investigated the transmission of MRSA where ST22-MRSA-IV is endemic on four wards using demographic data, patient and environmental screening, and molecular typing of isolates. A total of 939 patients were screened, 636 within 72 h of admission (on admission) and 303 >72 h after admission, and 1,252 environmental samples were obtained. Isolates were typed by spa, dru and pulsed-field gel electrophoresis (PFGE) typing. A composite dendrogram generated from the three sets of typing data was used to divide isolates into 'dendrogram groups' (DGs). Ten percent of patients (92/939) were MRSA-positive; 7 % (44/636) on admission and 16 % (48/303) >72 h after admission (p = 0.0007). MRSA was recovered from 5 % of environmental specimens (65/1,252). Most isolates from patients (97 %, 85/88) and the environment (97 %, 63/65) exhibited the ST22-MRSA-IV genotype. Four DGs (DG1, DG4, DG16 and DG17) accounted for 58 % of ST22-MRSA-IV isolates from patients. Epidemiological evidence suggested cross-transmission among 44/92 patients (48 %) but molecular typing confirmed probable cross-transmission in only 11 instances (13 %, 11/88), with the majority of cross-transmission (64 %; 7/11) occurring on one ward. In the setting of highly clonal endemic MRSA, the combination of local epidemiology, PFGE, spa and dru typing provided valuable insights into MRSA transmission.


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