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Molecular epidemiology of methicillin-susceptible Staphylococcus aureus in infants in a neonatal intensive care unit

Published online by Cambridge University Press:  16 September 2020

Hye-Kyung Cho Open the ORCID record for Hye-Kyung Cho [Opens in a new window] ,
Joshua N. Yang ,
Scott A. Cunningham ,
Kerryl E. Greenwood-Quaintance Open the ORCID record for Kerryl E. Greenwood-Quaintance [Opens in a new window] ,
Mary L. Dalton ,
Christopher A. Collura ,
Jennifer L. Fang ,
Angela L. Heinrich ,
W. Charles Huskins  and
Robin Patel Open the ORCID record for Robin Patel [Opens in a new window]
Hye-Kyung Cho
Affiliation:
Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo ClinicRochester, Minnesota
Joshua N. Yang
Affiliation:
Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo ClinicRochester, Minnesota
Scott A. Cunningham
Affiliation:
Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo ClinicRochester, Minnesota
Kerryl E. Greenwood-Quaintance
Affiliation:
Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo ClinicRochester, Minnesota
Mary L. Dalton
Affiliation:
Infection Prevention and Control, Mayo Clinic, Rochester, Minnesota
Christopher A. Collura
Affiliation:
Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
Jennifer L. Fang
Affiliation:
Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
Angela L. Heinrich
Affiliation:
Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota Department of Nursing, Mayo Clinic, Rochester, Minnesota
W. Charles Huskins
Affiliation:
Infection Prevention and Control, Mayo Clinic, Rochester, Minnesota Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
Robin Patel*
Affiliation:
Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo ClinicRochester, Minnesota Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
*
Author for correspondence: Robin Patel, E-mail: patel.robin@mayo.edu
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Abstract

Objective:

To investigate the molecular epidemiology of methicillin-susceptible Staphylococcus aureus (MSSA) in infants in a neonatal intensive care unit (NICU) using whole-genome sequencing.

Design:

Investigation of MSSA epidemiology in a NICU.

Setting:

Single-center, level IV NICU.

Methods:

Universal S. aureus screening was done using a single swab obtained from the anterior nares, axilla, and groin area of infants in the NICU on a weekly basis. Core genome multilocus sequence type (cgMLST) analysis was performed on MSSA isolates detected over 1 year (2018–2019).

Results:

In total, 68 MSSA-colonized infants were identified, and cgMLSTs of 67 MSSA isolates were analyzed. Overall, we identified 11 cgMLST isolate groups comprising 39 isolates (58%), with group sizes ranging from 2 to 10 isolates, and 28 isolates (42%) were unrelated to each other or any of the isolate groups. Cases of infants colonized by MSSA were scattered throughout the 1-year study period, and isolates belonging to the same cgMLST group were typically detected contemporaneously, over a few weeks or a few months. Overall, 13 infants (19.7%) developed MSSA infections: bacteremia (n = 3), wound infection (n = 5), conjunctivitis (n = 4), and cellulitis (n = 1). We detected no association between these clinically manifest infections and specific cgMLST groups.

Conclusions:

Although MSSA isolates in infants in a NICU showed high diversity, most were related to other isolates, albeit within small groups. cgMLST facilitates an understanding of the complex transmission dynamics of MSSA in NICUs, and these data can be used to inform better control strategies.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 12 , December 2020 , pp. 1402 - 1408
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Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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