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Whole-genome sequencing contained MRSA outbreak
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Researchers from the United Kingdom have successfully used DNA sequencing to track and contain an outbreak of methicillin-resistant Staphylococcus aureus, according to a report in The Lancet Infectious Diseases.
“Routine use of DNA sequencing could have detected this MRSA outbreak 6 months earlier than standard techniques and might well have prevented substantial illness and costs arising from MRSA transmission and subsequent infection,” Julian Parkhill, PhD, of the Wellcome Trust Sanger Institute in Cambridge, England, said in a press release. “Whole-genome sequencing of MRSA could make an important contribution to infection-control investigation and practice, allowing quicker identification, tracking and isolation of outbreaks than is currently possible.”
Parkhill and colleagues studied an MRSA outbreak in a special care baby unit at a National Health Service Foundation Trust. They performed whole-genome sequencing on DNA extracted from each MRSA isolate taken from colonized patients.
Initially, the hospital infection-control team had identified 12 infants who were colonized with MRSA in a 6-month period and suspected they were linked, but they were unable to prove it. After the researchers performed whole-genome sequencing, they confirmed that all of the cases were related. The researchers further identified that the outbreak had spread into the community. They also found that transmission occurred within the special care baby unit, between mothers in the postnatal ward and in the community.
Two months after the special care baby unit had been deep-cleaned, a new case of MRSA was identified in the unit, which was confirmed to be related to the earlier outbreak. The researchers hypothesized that a member of the hospital staff was carrying the MRSA strain. When 154 health care workers were screened, one was carrying the same strain of MRSA.
In an accompanying comment, Binh An Diep, MD, assistant professor at the University of California, San Francisco, said whole-genome sequencing may revolutionize outbreak investigations, being able to distinguish different strains compared with traditional methods.
Binh An Diep
“The rapidly reducing cost and increasing throughput of whole-genome sequencing might make it the gold standard molecular typing method for investigation of outbreaks and laboratory-based surveillance,” Diep wrote. “However, many questions about the appropriate use of this technique in the clinical microbiology laboratory will need to be addressed before broad adoption will be possible.”
For more information:
Diep B. Lancet Infect Dis. 2012;doi:10.1016/S1473-3099(12)70276-1.
Harris S. Lancet Infect Dis. 2012;doi:10.1016/S1473-3099(12)70268-2.
Disclosure: Parkhill has received support for travel from Illumina. Diep reports no relevant financial disclosures.