College of Medicine, Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Jacksonville, FL, USA.
Sci Rep. 2013;3:1902. doi: 10.1038/srep01902.
Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of healthcare-associated infections and significant contributor to healthcare cost. Community-associated-MRSA (CA-MRSA) strains have now invaded healthcare settings. A convenience sample of 97 clinical MRSA isolates was obtained from seven hospitals during a one-week period in 2010. We employed a framework integrating Staphylococcus protein A typing and full-genome next-generation sequencing. Single nucleotide polymorphisms were analyzed using phylodynamics. Twenty-six t002, 48 t008, and 23 other strains were identified. Phylodynamic analysis of 30 t008 strains showed ongoing exponential growth of the effective population size the basic reproductive number (R0) ranging from 1.24 to 1.34. No evidence of hospital clusters was identified. The lack of phylogeographic clustering suggests that community introduction is a major contributor to emergence of CA-MRSA strains within hospitals. Phylodynamic analysis provides a powerful framework to investigate MRSA transmission between the community and hospitals, an understanding of which is essential for control.
耐甲氧西林金黄色葡萄球菌（MRSA）是导致医疗保健相关感染的主要原因，也是医疗保健成本的重要因素。社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）菌株现已侵入医疗保健环境。在 2010 年的一周内，我们从七家医院获得了 97 株临床耐甲氧西林金黄色葡萄球菌分离株的便利样本。我们采用了一种整合金黄色葡萄球菌蛋白 A 分型和全基因组下一代测序的框架。使用系统发育动力学分析单核苷酸多态性。鉴定出 26 株 t002、48 株 t008 和 23 株其他菌株。对 30 株 t008 菌株的系统发育动力学分析表明，有效种群大小的持续指数增长，基本繁殖数（R0）范围为 1.24 至 1.34。未发现医院集群的证据。缺乏系统地理聚类表明，社区引入是导致医院内 CA-MRSA 菌株出现的主要因素。系统发育动力学分析为研究社区与医院之间耐甲氧西林金黄色葡萄球菌传播提供了一个强大的框架，了解这一点对于控制至关重要。
