Longitudinal, strain-specific Staphylococcus aureus introduction and transmission events in households of children with community-associated meticillin-resistant S aureus skin and soft tissue infection: a prospective cohort study

Mork, Ryan L.; Hogan, Patrick G.; Muenks, Carol E.; Boyle, Mary G.; Thompson, Ryley M.; Sullivan, Melanie; Morelli, John; Seigel, Jennifer; Orscheln, Rachel C.; Wardenburg, Juliane Bubeck; Gehlert, Sarah; Burnham, Carey Ann D.; Rzhetsky, Andrey; Fritz, Stephanie A.

doi:10.1016/s1473-3099(19)30570-5

Cited by 61 publications

(40 citation statements)

References 39 publications

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“…Phylodynamic models predicted lineage- and clade-specific infectious periods () that suggest prolonged durations of infection over several years in concordance with long-term cohort studies with lineage-resolved data (Table S1). Variation in our model estimates could reflect differential local modes of persistence in the host or community (70, 80), and is susceptible to factors that we were not able to explicitly model, including access to healthcare services and treatment amongst others. It should be noted that the lineage-wide averages of infectious periods may not reflect the considerable heterogeneity in carriage duration that likely arises from the distribution of permanent and transient carriers across the population (75, 76).…”

Section: Supplementary Discussionmentioning

confidence: 99%

Phylodynamic signatures in the emergence of community-associated MRSA

Steinig

Aglua

Duchêne

et al. 2021

Preprint

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Community-associated, methicillin-resistant Staphylococcus aureus (MRSA) lineages have emerged in many geographically distinct regions around the world during the past 30 years. Here, we apply consistent phylodynamic methods across multiple community-associated MRSA lineages to describe and contrast their patterns of emergence and dissemination. We generated whole genome sequencing data for the Australian sequence type (ST) 93-MRSA-IV from remote communities in Far North Queensland and Papua New Guinea, and the Bengal Bay ST772-MRSA-V clone from metropolitan communities in Pakistan. Increases in the effective reproduction number (Re) and sustained transmission (Re > 1) coincided with spread of progenitor methicillin-susceptible S. aureus (MSSA) in remote northern Australia, dissemination of the ST93-MRSA-IV geno-type into population centers on the Australian East Coast, and sub-sequent importation into the highlands of Papua New Guinea and Far North Queensland. Analysis of a ST772-MRSA-V cluster in Pakistan suggests that sustained transmission in the community following importation of resistant genotypes may be more common than previously thought. Applying the same phylodynamic methods to existing lineage datasets, we identified common signatures of epidemic growth in the emergence and epidemiological trajectory of community-associated S. aureus lineages from America, Asia, Australasia and Europe. Surges in Re were observed at the divergence of antibiotic resistant strains, coinciding with their establishment in regional population centers. Epidemic growth was also observed amongst drug-resistant MSSA clades in Africa and northern Australia. Our data suggest that the emergence of community-associated MRSA and MSSA lineages in the late 20th century was driven by a combination of antibiotic resistant genotypes and host epidemiology, leading to abrupt changes in lineage-wide transmission dynamics and sustained transmission in regional population centers.

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Section: Supplementary Discussionmentioning

confidence: 99%

Phylodynamic signatures in the emergence of community-associated MRSA

Steinig

Aglua

Duchêne

et al. 2021

Preprint

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“…36 It might be that children with early transient and persistent eczema have skin conditions (i.e., pH level, natural moisturizing factor and filaggrin gene mutations) more suitable for S. aureus overgrowth, increased contact with parents due to frequent comforting, S. aureus contaminated topical ointments and/or specific household conditions promoting S. aureus colonization (i.e., less frequent handwashing, shared towel use and shared bedrooms). [39][40][41][42] Also, since we only used one set of confounders mostly measured at early age, residual confounding could be greater for associations between exposures and outcomes at later ages.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Association between nasal and nasopharyngeal bacterial colonization in early life and eczema phenotypes

Duijts

Meel

et al. 2021

Clin Experimental Allergy

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Background: An association has been reported between early life Staphylococcus aureus nasal carriage and higher risk of childhood eczema, but it is unclear whether this relationship is causal and associations with other bacterial species are unclear.Objective: To examine the associations of early life nasal and nasopharyngeal bacterial carriage with eczema phenotypes, and the direction of any associations identified. Methods: Among 996 subjects of a population-based prospective cohort study, nasal swabs for Staphylococcus aureus, and nasopharyngeal swabs for Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae were collected and cultured from age 6 weeks to 6 years. Never, early, mid-, late transient and persistent eczema phenotypes were identified from parental-reported physician-diagnosed eczema from age 6 months until 10 years. Multinomial regression models and cross-lagged models were applied. Results: Staphylococcus aureus nasal carriage at 6 months was associated with an increased risk of early transient and persistent eczema (OR (95% CI): 2.69 (1.34, 5.39) and 4.17 (1.12, 15.51)). The associations between Staphylococcus aureus nasal carriage and eczema were mostly cross-sectional, and not longitudinal. No associations of Staphylococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenza nasopharyngeal bacterial carriage with eczema and eczema phenotypes were observed (OR range (95% CI): 0.71 (0.35, 1.44) to 1.77 (0.84, 3.73)).This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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“…Some specific MRSA clones, such as ST-59 and ST-508, are prevalent in China. However, the specific transmission mechanism of CA-MRSA is unclear (9).…”

Section: Introductionmentioning

confidence: 99%

Household Transmission of Community-Associated Methicillin-Resistant Staphylococcus Aureus

Zhu

Zhuang

et al. 2021

Front. Public Health

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Currently, the mechanism of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) transmission mechanism is unclear; however, it must be considered in conjunction with asymptomatic S. aureus strains colonization dynamics. This epidemiological study aimed to determine the role of the household in CA-MRSA transmission in China. Five patients with culture-confirmed CA-MRSA infection and five control patients were recruited from the Sir Run Run Shaw Hospital in Zhejiang, China, between December 2019 and January 2020. The household members of the patients, their pets, and environmental surfaces were sampled and screened for MRSA colonization. Mass spectrometry identification and antimicrobial susceptibility testing were performed on the MRSA isolates. Whole-genome sequencing and core genome multilocus sequence typing (cgMLST) were performed to determine the origin and transmission of the MRSA isolates in the households. Overall, 14 S. aureus-positive specimens (14.1%, 14/99) were obtained from the five households of patients with CA-MRSA infections, of which 12 (85.7%) were MRSA. The overall positivity of MRSA was 12.1% (12/99) among the samples from the CA-MRSA households, while no MRSA isolates were detected in the five control households. Most MRSA isolates belonged to epidemic CA-MRSA clones, such as ST59 (15/35, 42.9%) and ST508 (15/35, 42.9%). The cgMLST results confirmed that MRSA was transmitted among patients, contacts, and pets in the households and was present on environmental surfaces in the CA-MRSA patients' households. In conclusion, the study revealed that the home environment was an important MRSA reservoir. Therefore, focusing on MRSA decolonization in patients alone is not sufficient for infection control of CA-MRSA.

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Longitudinal, strain-specific Staphylococcus aureus introduction and transmission events in households of children with community-associated meticillin-resistant S aureus skin and soft tissue infection: a prospective cohort study

Cited by 61 publications

References 39 publications

Phylodynamic signatures in the emergence of community-associated MRSA

Phylodynamic signatures in the emergence of community-associated MRSA

Association between nasal and nasopharyngeal bacterial colonization in early life and eczema phenotypes

Household Transmission of Community-Associated Methicillin-Resistant Staphylococcus Aureus

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