Table 2. (Continued ) First Author, Year Title


Price JR et al 201431


WGS shows that patient- to-patient transmission rarely accounts for acquisition of S. aureus in an ICU


Study Design Population


Prospective cohort study


680 patients admitted to ICU in a teaching hospital in England, 44 acquired S. aureus (7 were unable to be typed)


Related Objective


To investigate the role of colonized patients as the source of new S. aureus acquisitions


Related Molecular Analysis


WGS spa typing


Transmission Event Definition


Using conventional criteria, acquisition of S. aureus with matching spa type and same susceptibility/resistance pattern of a strain cultured previously from a colonized patient with overlapping ICU stay. When, irrespective of overlapping stay, isolates had a 40 SNVs or less difference.


Long SW 201432


Absence of patient-to- patient intrahospital transmission of S. aureus as determined by WGS


Amissah NA et al 201533


Molecular


characterization S. aureus isolates transmitted between patients with Buruli ulcer (BU)


Moore G et al 201534


WGS in hierarchy with PFGE: the utility of this approach to establish possible sources of MRSA cross-transmission


Cross-


sectional study


Prospective cohort study


Sterile-site S. aureus isolates identified in Houston Medical Clinical Microbiology


11 BU patients attending Pakro Health Center in the Eastern region of Ghana who were screened for S. aureus


Prospective cohort study


40 potential transmission events were evaluated.


To identify patient-to- patient intrahospital transmission using high- resolution genetic analysis


To investigate possible patient-to-patient transmission events during wound care.


WGS


When isolates pairs had a pairwise distance of 40 SNPs or less with a plausible transmission chain or other epidemiological linkage.


MLVF WGS When the wound of a patient, previously not containing a particular S. aureus genotype, becomes colonized over time by an S. aureus with a genotype that is identical (same cluster type) with the genotype of an S. aureus isolate collected from the wound of another patient.


To explore the utility of WGS in a hierarchical approach with PFGE to help establish possible sources of MRSA cross- transmission in the intensive care setting


WGS PFGE When donor and recipient isolates were indistinguishable using PFGE and GWS or just PFGE pattern in case of pulsotypes non-dominant in the United Kingdom.


Related Finding


7 of 37 (18.9%) acquisitions were transmissions from other colonized patients.


No evidence of transmission of S. aureus between patients with sterile-site infections were identified.


At least 2 events (18%) of transmission of MRSA between patients were confirmed.


A probable source was identified for 14 of 40 events (35%); PFGE supported links between patients occupying the same bay, the same bed space, adjacent isolation rooms, and different wards.


Note. CRAB, carbapenem-resistant Acinetobacter baumannii, ICU, intensive care unit; IRPA, imipenem-resistant Pseudomonas aeruginosa; MICU, medical intensive care unit; MLVA, multilocus variable number of tandem repeats analysis; MLVF, multilocus variable number (MLVN) tandem repeat fingerprinting; MRSA, methicillin-resistant S. aureus; MSSA, methicillin-susceptible S. aureus; PFGE, pulse-field gel electrophoresis; SNP, single-nucleotide polymorphism; spa, Staphylococcus protein A; VREfm, Enterococcus faecium; VTNR, variable number tandem repeat; WG, whole-genome sequence.


454


Natalia Blanco et al


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