Altman D R, Sebra R, Hand J, Attie O, Deikus G, Carpini K W D, Patel G, Rana M, Arvelakis A, Grewal P, Dutta J, Rose H, Shopsin B, Daefler S, Schadt E, Kasarskis A, van Bakel H, Bashir A, Huprikar S
Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine, New York, NY.
Am J Transplant. 2014 Nov;14(11):2640-4. doi: 10.1111/ajt.12897. Epub 2014 Sep 22.
Donor-derived bacterial infection is a recognized complication of solid organ transplantation (SOT). The present report describes the clinical details and successful outcome in a liver transplant recipient despite transmission of methicillin-resistant Staphylococcus aureus (MRSA) from a deceased donor with MRSA endocarditis and bacteremia. We further describe whole genome sequencing (WGS) and complete de novo assembly of the donor and recipient MRSA isolate genomes, which confirms that both isolates are genetically 100% identical. We propose that similar application of WGS techniques to future investigations of donor bacterial transmission would strengthen the definition of proven bacterial transmission in SOT, particularly in the presence of highly clonal bacteria such as MRSA. WGS will further improve our understanding of the epidemiology of bacterial transmission in SOT and the risk of adverse patient outcomes when it occurs.
供体源性细菌感染是实体器官移植（SOT）中一种公认的并发症。本报告描述了一名肝移植受者的临床细节及成功治疗结果，尽管该受者从一名患有耐甲氧西林金黄色葡萄球菌（MRSA）心内膜炎和菌血症的已故供体处感染了MRSA。我们进一步描述了供体和受者MRSA分离株基因组的全基因组测序（WGS）及完整的从头组装，证实这两个分离株在基因上100%相同。我们建议，在未来对供体细菌传播的研究中类似地应用WGS技术，将加强对SOT中已证实的细菌传播的定义，特别是在存在如MRSA这种高度克隆性细菌的情况下。WGS将进一步增进我们对SOT中细菌传播流行病学的理解以及其发生时患者出现不良后果的风险的认识。
