Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing
<strong>Background:</strong> Considerable efforts are made to prevent nosocomial transmission of Staphylococcus aureus. Healthcare-workers (HCWs) have been implicated in outbreaks but lack of evidence from non-outbreak situations means that routine HCW screening and S. aureus eradication...
| Principais autores: | , , , , , , , , , , , |
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| Formato: | Journal article |
| Publicado em: |
Elsevier
2016
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| _version_ | 1826295647905513472 |
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| author | Price, J Cole, K Bexley, A Kostiou, V Eyre, D Golubchik, T Wilson, DJ Crook, D Walker, A Peto, T Llewelyn, M Paul, J |
| author_facet | Price, J Cole, K Bexley, A Kostiou, V Eyre, D Golubchik, T Wilson, DJ Crook, D Walker, A Peto, T Llewelyn, M Paul, J |
| author_sort | Price, J |
| collection | OXFORD |
| description | <strong>Background:</strong> Considerable efforts are made to prevent nosocomial transmission of Staphylococcus aureus. Healthcare-workers (HCWs) have been implicated in outbreaks but lack of evidence from non-outbreak situations means that routine HCW screening and S. aureus eradication are controversial. <strong>Methods:</strong> We performed a prospective observational study to determine how often S. aureus is transmitted from HCWs or the environment to patients on an intensive care/high dependency unit (ICU/HDU) where standard infection control measures were in place. Over fourteen months we systematically sampled HCWs, the environment and patients. Whole-genome sequencing data were used to define subtypes (≤40 single nucleotide variants (SNVs)) and infer recent transmission. <strong>Findings:</strong> 198 HCWs, 39 environmental locations and 1854 patients were sampled and 1819 isolates sequenced. S. aureus was detected in 29·5-39·7% HCWs at single four-weekly time-points and in 58·1% at least once. Monthly environmental sampling identified S. aureus in 7·7-50·0% of samples. During the study, 605 genetically distinct subtypes were identified (median SNV difference 273 (IQR 162-399)) at a rate of 38 (range 34-42) per month. Only 25 instances of transmission to patients were detected; seven from HCWs, two from the environment, 16 from other patients. <strong>Interpretation:</strong> In the presence of standard infection control measures HCWs infrequently act as sources of transmission to patients. S. aureus epidemiology in ICU/HDU is characterised by continuous ingress of distinct subtypes rather than transmission of genetically-related strains. |
| first_indexed | 2024-03-07T04:04:16Z |
| format | Journal article |
| id | oxford-uuid:c59c646c-4b3b-4b5a-a27c-99b413750c0e |
| institution | University of Oxford |
| last_indexed | 2024-03-07T04:04:16Z |
| publishDate | 2016 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:c59c646c-4b3b-4b5a-a27c-99b413750c0e2022-03-27T06:32:15ZTransmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencingJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c59c646c-4b3b-4b5a-a27c-99b413750c0eSymplectic Elements at OxfordElsevier2016Price, JCole, KBexley, AKostiou, VEyre, DGolubchik, TWilson, DJCrook, DWalker, APeto, TLlewelyn, MPaul, J<strong>Background:</strong> Considerable efforts are made to prevent nosocomial transmission of Staphylococcus aureus. Healthcare-workers (HCWs) have been implicated in outbreaks but lack of evidence from non-outbreak situations means that routine HCW screening and S. aureus eradication are controversial. <strong>Methods:</strong> We performed a prospective observational study to determine how often S. aureus is transmitted from HCWs or the environment to patients on an intensive care/high dependency unit (ICU/HDU) where standard infection control measures were in place. Over fourteen months we systematically sampled HCWs, the environment and patients. Whole-genome sequencing data were used to define subtypes (≤40 single nucleotide variants (SNVs)) and infer recent transmission. <strong>Findings:</strong> 198 HCWs, 39 environmental locations and 1854 patients were sampled and 1819 isolates sequenced. S. aureus was detected in 29·5-39·7% HCWs at single four-weekly time-points and in 58·1% at least once. Monthly environmental sampling identified S. aureus in 7·7-50·0% of samples. During the study, 605 genetically distinct subtypes were identified (median SNV difference 273 (IQR 162-399)) at a rate of 38 (range 34-42) per month. Only 25 instances of transmission to patients were detected; seven from HCWs, two from the environment, 16 from other patients. <strong>Interpretation:</strong> In the presence of standard infection control measures HCWs infrequently act as sources of transmission to patients. S. aureus epidemiology in ICU/HDU is characterised by continuous ingress of distinct subtypes rather than transmission of genetically-related strains. |
| spellingShingle | Price, J Cole, K Bexley, A Kostiou, V Eyre, D Golubchik, T Wilson, DJ Crook, D Walker, A Peto, T Llewelyn, M Paul, J Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing |
| title | Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing |
| title_full | Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing |
| title_fullStr | Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing |
| title_full_unstemmed | Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing |
| title_short | Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing |
| title_sort | transmission of staphylococcus aureus between health care workers the environment and patients in an intensive care unit a longitudinal cohort study based on whole genome sequencing |
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