HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, London, UK.
Reference Services Division, National Infection Service, UK Health Security Agency, London, UK.
J Infect. 2023 Sep;87(3):210-219. doi: 10.1016/j.jinf.2023.06.020. Epub 2023 Jun 30.
Increased incidence of neonatal Staphylococcus capitis bacteraemia in summer 2020, London, raised suspicion of widespread multidrug-resistant clone NRCS-A. We set out to investigate the molecular epidemiology of this clone in neonatal units (NNUs) across the UK.
We conducted whole-genome sequencing (WGS) on presumptive S. capitis NRCS-A isolates collected from infants admitted to nationwide NNUs and from environmental sampling in two distinct NNUs in 2021. Previously published S. capitis genomes were added for comparison. Genetic clusters of NRCS-A isolates were defined based on core-genome single-nucleotide polymorphisms.
We analysed WGS data of 838 S. capitis isolates and identified 750 NRCS-A isolates. We discovered a possible UK-specific NRCS-A lineage consisting of 611 isolates collected between 2005 and 2021. We determined 28 genetic clusters of NRCS-A isolates, which covered all geographical regions in the UK, and isolates of 19 genetic clusters were found in ≥2 regions, suggesting inter-regional spread. Within the NRCS-A clone, strong genetic relatedness was identified between contemporary clinical and incubator-associated fomite isolates and between clinical isolates associated with inter-hospital infant transfer.
This WGS-based study confirms the dispersion of S. capitis NRCS-A clone amongst NNUs across the UK and urges research on improving clinical management of neonatal S. capitis infection.
2020 年夏季，伦敦新生儿头葡萄球菌菌血症的发病率上升，这让人怀疑存在广泛的多药耐药克隆 NRCS-A。我们着手调查该克隆在英国新生儿病房（NNU）中的分子流行病学情况。
我们对 2021 年从全国性 NNU 住院婴儿和两个不同 NNU 的环境样本中采集的疑似头葡萄球菌 NRCS-A 分离株进行了全基因组测序（WGS）。同时，我们还添加了先前发表的头葡萄球菌基因组进行比较。基于核心基因组单核苷酸多态性，定义了 NRCS-A 分离株的遗传聚类。
我们分析了 838 株头葡萄球菌的 WGS 数据，鉴定出 750 株 NRCS-A 分离株。我们发现了一种可能具有英国特异性的 NRCS-A 谱系，由 2005 年至 2021 年间采集的 611 株分离株组成。我们确定了 28 个 NRCS-A 分离株的遗传聚类，这些聚类覆盖了英国的所有地理区域，有 19 个遗传聚类的分离株在≥2 个地区被发现，提示存在区域间传播。在 NRCS-A 克隆内，我们发现了当代临床和孵化器相关污染分离株与医院间婴儿转移相关临床分离株之间存在很强的遗传相关性。
这项基于 WGS 的研究证实了头葡萄球菌 NRCS-A 克隆在英国 NNU 中的传播，并敦促研究改善新生儿头葡萄球菌感染的临床管理。
