title: Whole genome sequencing to investigate a putative outbreak of the virulent community-associated methicillin-resistantStaphylococcus aureusST93 clone in a remote Indigenous community.
abstract: We report two cases of severe pneumonia due to clone ST93 methicillin-resistantStaphylococcus aureus(MRSA) presenting from a remote Australian Indigenous community within a 2-week period, and the utilization of whole genome sequences to determine whether these were part of an outbreak.S. aureuswas isolated from 12 of 92 nasal swabs collected from 25 community households (including the two index households); one isolate was ST93. Three of five skin lesionS. aureusisolates obtained at the community were ST93. Whole genome sequencing of the ST93 isolates from this study and a further 20 ST93 isolates from the same region suggested that recent transmission and progression to disease had not taken place. The proximity in time and space of the two severe pneumonia cases is probably a reflection of the high burden of disease due to ST93 MRSA in this population where skin infections and household crowding are common.
authors.affiliation: 3​Centre for Disease Control, Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia.|2​Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia.|1​Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
authors.forename: Ella M
authors.initials: EM
authors.lastname: Meumann
authors.affiliation: 1​Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
authors.forename: Patiyan
authors.initials: P
authors.lastname: Andersson
authors.affiliation: 2​Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Yeaman
authors.affiliation: 2​Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Oldfield
authors.affiliation: 1​Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
authors.forename: Rachael
authors.initials: R
authors.lastname: Lilliebridge
authors.affiliation: 4​Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Bentley
authors.affiliation: 3​Centre for Disease Control, Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia.
authors.forename: Vicki
authors.initials: V
authors.lastname: Krause
authors.affiliation: 5​School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Miles
authors.initials: M
authors.lastname: Beaman
authors.affiliation: 1​Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.|2​Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Currie
authors.affiliation: 1​Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Holt
authors.affiliation: 1​Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Giffard
authors.affiliation: 1​Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.|2​Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
authors.forename: Steven Y C
authors.initials: SYC
authors.lastname: Tong
mesh_terms: D001315:Australia / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D004196:Disease Outbreaks; D016680:Genome, Bacterial / Q000235:genetics*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics*; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D000073336:Whole Genome Sequencing
keywords: MRSA outbreak Indigenous whole genome sequencing