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Absence of Patient-to-Patient Intrahospital Transmission of Staphylococcus aureus as Determined by Whole-Genome Sequencing

机译：全基因组测序确定患者到患者的金黄色葡萄球菌医院内传播的缺乏

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Nosocomial transmission of pathogens is a major health care challenge. The increasing spread of antibiotic-resistant strains represents an ongoing threat to public health. Previous Staphylococcus aureus transmission studies have focused on transmission of S.?aureus between asymptomatic carriers or used low-resolution typing methods such as multilocus sequence typing (MLST) or spa typing. To identify patient-to-patient intrahospital transmission using high-resolution genetic analysis, we sequenced the genomes of a consecutive set of 398 S.?aureus isolates from sterile-site infections. The S.?aureus strains were collected from four hospitals in the Houston Methodist Hospital System over a 6-month period. Importantly, we discovered no evidence of transmission of S.?aureus between patients with sterile-site infections. The lack of intrahospital transmission may reflect a fundamental difference between day-to-day transmission events in the hospital setting and the more frequently studied outbreak scenarios. >IMPORTANCE Previous studies have suggested that nosocomial transmission of S.?aureus is common. Our data revealed an unexpected lack of evidence for intrahospital transmission of S.?aureus between patients with invasive infections. This finding has important implications for hospital infection control and public health efforts. In addition, our data demonstrate that highly related pools of S.?aureus strains exist in the community which may complicate outbreak investigations.
机译：病原体的医院传播是主要的卫生保健挑战。抗生素抗性菌株的扩散不断增加，对公共健康构成了持续威胁。以前的金黄色葡萄球菌传播研究主要集中在无症状携带者之间金黄色葡萄球菌的传播，或者使用低分辨率的分型方法，例如多基因座序列分型（MLST）或 spa 键入。为了使用高分辨率遗传分析识别患者之间的医院内传播，我们对来自无菌位点感染的398个金黄色葡萄球菌分离株的连续基因组进行了测序。在六个月的时间内，从休斯顿卫理公会医院系统的四家医院中收集了金黄色葡萄球菌。重要的是，我们没有发现在无菌部位感染患者之间传播金黄色葡萄球菌的证据。缺乏医院内传播可能反映出医院环境中的日常传播事件与更频繁研究的暴发情景之间的根本差异。 >重要性先前的研究表明，金黄色葡萄球菌的医院内传播很普遍。我们的数据表明，出乎意料的缺乏证据表明浸润性感染患者之间 S.?aureus 在医院内传播。这一发现对医院感染控制和公共卫生工作具有重要意义。此外，我们的数据表明，社区中存在高度相关的金黄色葡萄球菌菌株，可能会使暴发调查更加复杂。

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