Building a genomic framework for prospective MRSA surveillance in the United Kingdom and the Republic of Ireland
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
The correct interpretation of microbial sequencing data applied to surveillance and outbreak investigation depends on accessible genomic databases to provide vital genetic context. Our aim was to construct and describe a United Kingdom MRSA database containing over 1000 methicillin-resistant Staphylococcus aureus (MRSA) genomes drawn from England, Northern Ireland, Wales, Scotland, and the Republic of Ireland over a decade. We sequenced 1013 MRSA submitted to the British Society for Antimicrobial Chemotherapy by 46 laboratories between 2001 and 2010. Each isolate was assigned to a regional healthcare referral network in England and was otherwise grouped based on country of origin. Phylogenetic reconstructions were used to contextualize MRSA outbreak investigations and to detect the spread of resistance. The majority of isolates (n = 783, 77%) belonged to CC22, which contains the dominant United Kingdom epidemic clone (EMRSA-15). There was marked geographic structuring of EMRSA-15, consistent with widespread dissemination prior to the sampling decade followed by local diversification. The addition of MRSA genomes from two outbreaks and one pseudo-outbreak demonstrated the certainty with which outbreaks could be confirmed or refuted. We identified local and regional differences in antibiotic resistance profiles, with examples of local expansion, as well as widespread circulation of mobile genetic elements across the bacterial population. We have generated a resource for the future surveillance and outbreak investigation of MRSA in the United Kingdom and Ireland and have shown the value of this during outbreak investigation and tracking of antimicrobial resistance.
Date Issued
2016-02-01
Date Acceptance
2015-12-14
Citation
Genome Research, 2016, 26 (2), pp.263-270
ISSN
1549-5469
Publisher
Cold Spring Harbor Laboratory Press
Start Page
263
End Page
270
Journal / Book Title
Genome Research
Volume
26
Issue
2
Copyright Statement
© 2016 Reuter et al. This article, published in Genome Research, is available under
a Creative Commons License (Attribution 4.0 International), as described at
http://creativecommons.org/licenses/by/4.0/.
a Creative Commons License (Attribution 4.0 International), as described at
http://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
National Institute for Health Research
Wellcome Trust
Medical Research Council (MRC)
Wellcome Trust
Grant Number
NF-SI-0507-10336
089472/Z/09/Z
RG 57593
099202/Z/12/Z
Subjects
Science & Technology
Life Sciences & Biomedicine
Biochemistry & Molecular Biology
Biotechnology & Applied Microbiology
Genetics & Heredity
RESISTANT STAPHYLOCOCCUS-AUREUS
METHICILLIN-RESISTANT
PHYLOGENETIC TREES
TRANSMISSION
BACTEREMIA
EMERGENCE
EVOLUTION
OUTBREAK
CLONES
SPREAD
Publication Status
Published