title: Whole-Genome Sequencing for the Investigation of a Hospital Outbreak of MRSA in China.
abstract: Staphylococcus aureus is a globally disseminated drug-resistant bacterial species. It remains a leading cause of hospital-acquired infection, primarily among immunocompromised patients. In 2012, the Affiliated People's Hospital of Jiangsu University experienced a putative outbreak of methicillin-resistant S. aureus (MRSA) that affected 12 patients in the Neurosurgery Department. In this study, whole-genome sequencing (WGS) was used to gain insight into the epidemiology of the outbreak caused by MRSA, and traditional bacterial genotyping approaches were also applied to provide supportive evidence for WGS. We sequenced the DNA from 6 isolates associated with the outbreak. Phylogenetic analysis was constructed by comparing single-nucleotide polymorphisms (SNPs) in the core genome of 6 isolates in the present study and another 3 referenced isolates from GenBank. Of the 6 MRSA sequences in the current study, 5 belonged to the same group, clustering with T0131, while the other one clustered closely with TW20. All of the isolates were identified as ST239-SCCmecIII clones. Whole-genome analysis revealed that four of the outbreak isolates were more tightly clustered into a group and SA13002 together with SA13009 were distinct from the outbreak strains, which were considered non-outbreak strains. Based on the sequencing results, the antibiotic-resistance gene status (present or absent) was almost perfectly concordant with the results of phenotypic susceptibility testing. Various toxin genes were also analyzed successfully. Our analysis demonstrates that using traditional molecular methods and WGS can facilitate the identification of outbreaks and help to control nosocomial transmission.
authors.affiliation: Department of Clinical Laboratory, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, China.|Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China.
authors.forename: Zhenzhen
authors.initials: Z
authors.lastname: Kong
authors.affiliation: Department of Clinical Laboratory, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, China.|Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China.
authors.forename: Peipei
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Department of Clinical Laboratory, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, China.|Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China.
authors.forename: Haibing
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, PR China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Qin
authors.affiliation: Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China.
authors.forename: Zhaoliang
authors.initials: Z
authors.lastname: Su
authors.affiliation: Department of Clinical Laboratory, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, China.
authors.forename: Shengjun
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China.
authors.forename: Huaxi
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Clinical Laboratory, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Chen
mesh_terms: D015373:Bacterial Typing Techniques; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D023281:Genomics; D006761:Hospitals; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification / Q000502:physiology; D020641:Polymorphism, Single Nucleotide; D017421:Sequence Analysis; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*