Department of Clinical Microbiology, Hvidovre University Hospital, Denmark.
Euro Surveill. 2015 Apr 30;20(17):21112. doi: 10.2807/1560-7917.es2015.20.17.21112.
Typing of meticillin resistant Staphylococcus aureus (MRSA) by whole genome sequencing (WGS) is performed routinely in Copenhagen since January 2013. We describe the relatedness, based on WGS data and epidemiological data, of 341 MRSA isolates. These comprised all MRSA (n = 300) identified in Copenhagen in the first five months of 2013. Moreover, because MRSA of staphylococcal protein A (spa)-type 304 (t304), sequence type (ST) 6 had been associated with a continuous neonatal ward outbreak in Copenhagen starting in 2011, 41 t304 isolates collected in the city between 2010 and 2012 were also included. Isolates from 2013 found to be of t304, ST6 (n=14) were compared to the 41 earlier isolates. In the study, isolates of clonal complex (CC) 22 were examined in detail, as this CC has been shown to include the hospital-acquired epidemic MRSA (EMRSA-15) clone. Finally, all MRSA ST80 were also further analysed, as representatives of an important community-acquired MRSA in Europe. Overall the analysis identified 85 spa-types and 35 STs from 17 CCs. WGS confirmed the relatedness of epidemiologically linked t304 neonatal outbreak isolates. Several non-outbreak related patients had isolates closely related to the neonatal isolates suggesting unrecognised community chains of transmission and insufficient epidemiological data. Only four CC22 isolates were related to EMRSA-15. No community spread was observed among the 13 ST80 isolates. WGS successfully replaced conventional typing and added information to epidemiological surveillance. Creation of a MRSA database allows clustering of isolates based on single nucleotide polymorphism (SNP) calling and has improved our understanding of MRSA transmission.
自 2013 年 1 月以来，哥本哈根常规进行全基因组测序（WGS）以鉴定耐甲氧西林金黄色葡萄球菌（MRSA）。我们根据 WGS 数据和流行病学数据描述了 341 株 MRSA 分离株的相关性。这些分离株包括 2013 年 1 月至 5 月哥本哈根发现的所有 MRSA（n=300）。此外，由于葡萄球菌蛋白 A（spa）型 304（t304）、序列型（ST）6 的 MRSA 与 2011 年开始在哥本哈根的新生儿病房连续暴发有关，因此还包括 2010 年至 2012 年期间在该市收集的 41 株 t304 分离株。发现 2013 年的 t304、ST6（n=14）分离株与之前的 41 株分离株进行了比较。在研究中，详细检查了克隆复合体（CC）22 的分离株，因为该 CC 已被证明包括医院获得性流行型耐甲氧西林金黄色葡萄球菌（EMRSA-15）克隆。最后，还对所有 ST80 型 MRSA 进行了进一步分析，因为它们是欧洲重要的社区获得性耐甲氧西林金黄色葡萄球菌的代表。总的来说，分析确定了 17 个 CC 中的 85 个 spa 型和 35 个 ST。WGS 证实了与流行病学相关的 t304 新生儿暴发分离株的相关性。一些与暴发无关的患者的分离株与新生儿分离株密切相关，这表明存在未被识别的社区传播链和不足的流行病学数据。只有 4 株 CC22 分离株与 EMRSA-15 相关。在 13 株 ST80 分离株中未观察到社区传播。WGS 成功替代了常规分型，并为流行病学监测提供了更多信息。建立一个耐甲氧西林金黄色葡萄球菌数据库，允许根据单核苷酸多态性（SNP）调用对分离株进行聚类，从而提高了我们对耐甲氧西林金黄色葡萄球菌传播的理解。
