title: Transmission of methicillin-resistant Staphylococcus aureus via deceased donor liver transplantation confirmed by whole genome sequencing.
abstract: Donor-derived bacterial infection is a recognized complication of solid organ transplantation (SOT). The present report describes the clinical details and successful outcome in a liver transplant recipient despite transmission of methicillin-resistant Staphylococcus aureus (MRSA) from a deceased donor with MRSA endocarditis and bacteremia. We further describe whole genome sequencing (WGS) and complete de novo assembly of the donor and recipient MRSA isolate genomes, which confirms that both isolates are genetically 100% identical. We propose that similar application of WGS techniques to future investigations of donor bacterial transmission would strengthen the definition of proven bacterial transmission in SOT, particularly in the presence of highly clonal bacteria such as MRSA. WGS will further improve our understanding of the epidemiology of bacterial transmission in SOT and the risk of adverse patient outcomes when it occurs.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine, New York, NY.
authors.forename: D R
authors.initials: DR
authors.lastname: Altman
authors.forename: R
authors.initials: R
authors.lastname: Sebra
authors.forename: J
authors.initials: J
authors.lastname: Hand
authors.forename: O
authors.initials: O
authors.lastname: Attie
authors.forename: G
authors.initials: G
authors.lastname: Deikus
authors.forename: K W D
authors.initials: KW
authors.lastname: Carpini
authors.forename: G
authors.initials: G
authors.lastname: Patel
authors.forename: M
authors.initials: M
authors.lastname: Rana
authors.forename: A
authors.initials: A
authors.lastname: Arvelakis
authors.forename: P
authors.initials: P
authors.lastname: Grewal
authors.forename: J
authors.initials: J
authors.lastname: Dutta
authors.forename: H
authors.initials: H
authors.lastname: Rose
authors.forename: B
authors.initials: B
authors.lastname: Shopsin
authors.forename: S
authors.initials: S
authors.lastname: Daefler
authors.forename: E
authors.initials: E
authors.lastname: Schadt
authors.forename: A
authors.initials: A
authors.lastname: Kasarskis
authors.forename: H
authors.initials: H
authors.lastname: van Bakel
authors.forename: A
authors.initials: A
authors.lastname: Bashir
authors.forename: S
authors.initials: S
authors.lastname: Huprikar
mesh_terms: D000328:Adult; D002102:Cadaver; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D016680:Genome, Bacterial; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification*; D017422:Sequence Analysis, DNA; D013203:Staphylococcal Infections / Q000382:microbiology / Q000635:transmission*; D014019:Tissue Donors
chemical_list: D004269:DNA, Bacterial