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. 2022 Nov 18;12(1):19826.
doi: 10.1038/s41598-022-24363-7.

Outbreak investigation including molecular characterization of community associated methicillin-resistant Staphylococcus aureus in a primary and secondary school in Eastern Switzerland

Frederike Waldeck #  1   2 , Salome N Seiffert #  3 , Susanne Manser  4 , Danuta Zemp  5 , Angela Walt  6 , Christoph Berger  7 , Werner C Albrich  1 , Matthias Schlegel  1 , Tim Roloff  8   9   10 , Adrian Egli  8   9   10 , Oliver Nolte  3 , Christian R Kahlert  11   12
Affiliations

Outbreak investigation including molecular characterization of community associated methicillin-resistant Staphylococcus aureus in a primary and secondary school in Eastern Switzerland

Frederike Waldeck et al. Sci Rep. .

Abstract

At our tertiary children's hospital, infections with newly detected methicillin-resistant Staphylococcus aureus (MRSA) among children attending primary (age 6-12 years) and secondary school (age 13-16 years) nearly doubled in 2018 compared to previous years. This observation initiated an epidemiological outbreak investigation including phenotypic (susceptibility testing) and genotypic (whole genome sequencing) characterization of the isolates. In addition, a cross-sectional study was conducted to determine source of the outbreak, colonization frequency and to identify risk factors for transmission using a questionnaire. As a result, 49 individuals were detected with 57 corresponding isolates. Based on the case definition combined with whole genome sequencing, a core cluster was identified that shared common genetic features and a similar antimicrobial susceptibility pattern (efflux-mediated macrolide resistance, tetracycline susceptibility along with presence of Panton-Valentine leukocidin). Epidemiologic evaluation identified a distinct school as a common risk factor. However, the source of the clustered infections within that school could not be further specified. No further cases could be detected after decolonization of infected and colonized children.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Case definitions based on microbiological results used in this study. AST antimicrobial susceptibility testing, cgMLST core genome multi-locus sequence typing, WGS whole-genome sequencing, MRSA methicillin-resistant Staphylococcus aureus, MSSA methicillin-susceptible Staphylococcus aureus, ST sequence type, SNP single nucleotide polymorphism.
Figure 2
Figure 2
Epidemic curve of confirmed and probable cases with measures initiated during outbreak investigation (n = 33).
Figure 3
Figure 3
Phylogenetic single nucleotide polymorphisms (SNP) tree of the core cluster (N = 31).
Figure 4
Figure 4
Graphical representation of micro-evolution within the ST5 cluster over time.
See this image and copyright information in PMC

References

    1. Olearo F, Albrich WC, Vernaz N, Harbarth S, Kronenberg A, Swiss Centre For Antibiotic Resistance Anresis Staphylococcus aureus and methicillin resistance in Switzerland: Regional differences and trends from 2004 to 2014. Swiss Med. Wkly. 2016;146:w14339. - PubMed
    1. Heininger U, Datta F, Gervaix A, et al. Prevalence of nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) in children a multicenter cross-sectional study. Pediatr. Infect. Dis. J. 2007;26:544–546. doi: 10.1097/INF.0b013e31804d244a. - DOI - PubMed
    1. Johnson K, Frei R, Heininger U. Prospective, cross-sectional study on MSSA and MRSA colonisation in hospitalised children. Eur. J. Pediatr. 2015;174:1255–1262. doi: 10.1007/s00431-015-2606-5. - DOI - PubMed
    1. Herold BC, Immergluck LC, Maranan MC, et al. Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA. 1998;279:593–598. doi: 10.1001/jama.279.8.593. - DOI - PubMed
    1. DeLeo FR, Otto M, Kreiswirth BN, Chambers HF. Community-associated meticillin-resistant Staphylococcus aureus. Lancet. 2010;375:1557–1568. doi: 10.1016/S0140-6736(09)61999-1. - DOI - PMC - PubMed

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