title: Transmission of methicillin-resistant Staphylococcus aureus infection through solid organ transplantation: confirmation via whole genome sequencing.
abstract: We describe two cases of donor-derived methicillin-resistant Staphylococcus aureus (MRSA) bacteremia that developed after transplantation of organs from a common donor who died from acute MRSA endocarditis. Both recipients developed recurrent MRSA infection despite appropriate antibiotic therapy, and required prolonged hospitalization and hospital readmission. Comparison of S. aureus whole genome sequence of DNA extracted from fixed donor tissue and recipients' isolates confirmed donor-derived transmission. Current guidelines emphasize the risk posed by donors with bacteremia from multidrug-resistant organisms. This investigation suggests that, particularly in the setting of donor endocarditis, even a standard course of prophylactic antibiotics may not be sufficient to prevent donor-derived infection.
authors.affiliation: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA; Centers for Disease Control and Prevention, Epidemic Intelligence Service, Office of Surveillance Epidemiology and Laboratory Services, Atlanta, GA.
authors.forename: J M
authors.initials: JM
authors.lastname: Wendt
authors.forename: D
authors.initials: D
authors.lastname: Kaul
authors.forename: B M
authors.initials: BM
authors.lastname: Limbago
authors.forename: M
authors.initials: M
authors.lastname: Ramesh
authors.forename: S
authors.initials: S
authors.lastname: Cohle
authors.forename: A M
authors.initials: AM
authors.lastname: Denison
authors.forename: E M
authors.initials: EM
authors.lastname: Driebe
authors.forename: J K
authors.initials: JK
authors.lastname: Rasheed
authors.forename: S R
authors.initials: SR
authors.lastname: Zaki
authors.forename: D M
authors.initials: DM
authors.lastname: Blau
authors.forename: C D
authors.initials: CD
authors.lastname: Paddock
authors.forename: L K
authors.initials: LK
authors.lastname: McDougal
authors.forename: D M
authors.initials: DM
authors.lastname: Engelthaler
authors.forename: P S
authors.initials: PS
authors.lastname: Keim
authors.forename: C C
authors.initials: CC
authors.lastname: Roe
authors.forename: H
authors.initials: H
authors.lastname: Akselrod
authors.forename: M J
authors.initials: MJ
authors.lastname: Kuehnert
authors.forename: S V
authors.initials: SV
authors.lastname: Basavaraju
mesh_terms: D004269:DNA, Bacterial / Q000235:genetics; D016680:Genome, Bacterial; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification*; D016377:Organ Transplantation / Q000009:adverse effects*; D020641:Polymorphism, Single Nucleotide; D017422:Sequence Analysis, DNA; D013203:Staphylococcal Infections / Q000382:microbiology / Q000635:transmission*; D014019:Tissue Donors
chemical_list: D004269:DNA, Bacterial