Skip to content

Research at St Andrews

MRSA transmission dynamics among interconnected acute, intermediate-term, and long-term healthcare facilities in Singapore

Research output: Contribution to journalArticle

DOI

Open Access permissions

Open

Standard

MRSA transmission dynamics among interconnected acute, intermediate-term, and long-term healthcare facilities in Singapore. / Chow, Angela; Lim, Vanessa W.; Khan, Ateeb; Pettigrew, Kerry; Lye, David C. B.; Kanagasabai, Kala; Phua, Kelvin; Krishnan, Prabha; Ang, Brenda; Marimuthu, Kalisvar; Hon, Pei-Yun; Koh, Jocelyn; Leong, Ian; Parkhill, Julian; Hsu, Li-Yang; Holden, Matthew T G.

In: Clinical Infectious Diseases, Vol. 64, No. suppl_2, 15.05.2017, p. S76-S81.

Research output: Contribution to journalArticle

Harvard

Chow, A, Lim, VW, Khan, A, Pettigrew, K, Lye, DCB, Kanagasabai, K, Phua, K, Krishnan, P, Ang, B, Marimuthu, K, Hon, P-Y, Koh, J, Leong, I, Parkhill, J, Hsu, L-Y & Holden, MTG 2017, 'MRSA transmission dynamics among interconnected acute, intermediate-term, and long-term healthcare facilities in Singapore', Clinical Infectious Diseases, vol. 64, no. suppl_2, pp. S76-S81. https://doi.org/10.1093/cid/cix072

APA

Chow, A., Lim, V. W., Khan, A., Pettigrew, K., Lye, D. C. B., Kanagasabai, K., ... Holden, M. T. G. (2017). MRSA transmission dynamics among interconnected acute, intermediate-term, and long-term healthcare facilities in Singapore. Clinical Infectious Diseases, 64(suppl_2), S76-S81. https://doi.org/10.1093/cid/cix072

Vancouver

Chow A, Lim VW, Khan A, Pettigrew K, Lye DCB, Kanagasabai K et al. MRSA transmission dynamics among interconnected acute, intermediate-term, and long-term healthcare facilities in Singapore. Clinical Infectious Diseases. 2017 May 15;64(suppl_2):S76-S81. https://doi.org/10.1093/cid/cix072

Author

Chow, Angela ; Lim, Vanessa W. ; Khan, Ateeb ; Pettigrew, Kerry ; Lye, David C. B. ; Kanagasabai, Kala ; Phua, Kelvin ; Krishnan, Prabha ; Ang, Brenda ; Marimuthu, Kalisvar ; Hon, Pei-Yun ; Koh, Jocelyn ; Leong, Ian ; Parkhill, Julian ; Hsu, Li-Yang ; Holden, Matthew T G. / MRSA transmission dynamics among interconnected acute, intermediate-term, and long-term healthcare facilities in Singapore. In: Clinical Infectious Diseases. 2017 ; Vol. 64, No. suppl_2. pp. S76-S81.

Bibtex - Download

@article{bfda9d09c98847f992f0ec3b8428d0ba,
title = "MRSA transmission dynamics among interconnected acute, intermediate-term, and long-term healthcare facilities in Singapore",
abstract = "Background: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common healthcare-associated multidrug-resistant organism. Despite the interconnectedness between acute care hospitals (ACHs) and intermediate- and long-term care facilities (ILTCFs), the transmission dynamics of MRSA between healthcare settings is not well understood.Methods: We conducted a cross-sectional study in a network comprising an ACH and 5 closely affiliated ILTCFs in Singapore. A total of 1700 inpatients were screened for MRSA over a 6-week period in 2014. MRSA isolates underwent whole-genome sequencing, with a pairwise single-nucleotide polymorphism (Hamming distance) cutoff of 60 core genome single-nucleotide polymorphisms used to define recent transmission clusters (clades) for the 3 major clones.Results: MRSA prevalence was significantly higher in intermediate-term (29.9{\%}) and long-term (20.4{\%}) care facilities than in the ACH (11.8{\%}) (P < .001). The predominant clones were sequence type [ST] 22 (n = 183; 47.8{\%}), ST45 (n = 129; 33.7{\%}), and ST239 (n = 26; 6.8{\%}), with greater diversity of STs in ILTCFs relative to the ACH. A large proportion of the clades in ST22 (14 of 21 clades; 67{\%}) and ST45 (7 of 13; 54{\%}) included inpatients from the ACH and ILTCFs. The most frequent source of the interfacility transmissions was the ACH (n = 28 transmission events; 36.4{\%}).Conclusions: MRSA transmission dynamics between the ACH and ILTCFs were complex. The greater diversity of STs in ILTCFs suggests that the ecosystem in such settings might be more conducive for intrafacility transmission events. ST22 and ST45 have successfully established themselves in ILTCFs. The importance of interconnected infection prevention and control measures and strategies cannot be overemphasized.",
keywords = "Whole-genome sequencing, MRSA, Transmission, Intermediate-care facilities, Long-term care facilities",
author = "Angela Chow and Lim, {Vanessa W.} and Ateeb Khan and Kerry Pettigrew and Lye, {David C. B.} and Kala Kanagasabai and Kelvin Phua and Prabha Krishnan and Brenda Ang and Kalisvar Marimuthu and Pei-Yun Hon and Jocelyn Koh and Ian Leong and Julian Parkhill and Li-Yang Hsu and Holden, {Matthew T G}",
note = "This work was supported by the Ministry of Health, Singapore (Communicable Diseases–Public Health Research Grant), the Wellcome Trust (Institutional Strategic Support Fund award [grant 097831/Z/11/Z] to the University of St Andrews Bioinformatics Unit), and the Scottish Infection Research Network and Chief Scientist Office (Scottish Healthcare Associated Infection Prevention Institute consortium funding [Chief Scientist Office reference SIRN10] to K. P. and M. T. G. H.).",
year = "2017",
month = "5",
day = "15",
doi = "10.1093/cid/cix072",
language = "English",
volume = "64",
pages = "S76--S81",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "suppl_2",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - MRSA transmission dynamics among interconnected acute, intermediate-term, and long-term healthcare facilities in Singapore

AU - Chow, Angela

AU - Lim, Vanessa W.

AU - Khan, Ateeb

AU - Pettigrew, Kerry

AU - Lye, David C. B.

AU - Kanagasabai, Kala

AU - Phua, Kelvin

AU - Krishnan, Prabha

AU - Ang, Brenda

AU - Marimuthu, Kalisvar

AU - Hon, Pei-Yun

AU - Koh, Jocelyn

AU - Leong, Ian

AU - Parkhill, Julian

AU - Hsu, Li-Yang

AU - Holden, Matthew T G

N1 - This work was supported by the Ministry of Health, Singapore (Communicable Diseases–Public Health Research Grant), the Wellcome Trust (Institutional Strategic Support Fund award [grant 097831/Z/11/Z] to the University of St Andrews Bioinformatics Unit), and the Scottish Infection Research Network and Chief Scientist Office (Scottish Healthcare Associated Infection Prevention Institute consortium funding [Chief Scientist Office reference SIRN10] to K. P. and M. T. G. H.).

PY - 2017/5/15

Y1 - 2017/5/15

N2 - Background: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common healthcare-associated multidrug-resistant organism. Despite the interconnectedness between acute care hospitals (ACHs) and intermediate- and long-term care facilities (ILTCFs), the transmission dynamics of MRSA between healthcare settings is not well understood.Methods: We conducted a cross-sectional study in a network comprising an ACH and 5 closely affiliated ILTCFs in Singapore. A total of 1700 inpatients were screened for MRSA over a 6-week period in 2014. MRSA isolates underwent whole-genome sequencing, with a pairwise single-nucleotide polymorphism (Hamming distance) cutoff of 60 core genome single-nucleotide polymorphisms used to define recent transmission clusters (clades) for the 3 major clones.Results: MRSA prevalence was significantly higher in intermediate-term (29.9%) and long-term (20.4%) care facilities than in the ACH (11.8%) (P < .001). The predominant clones were sequence type [ST] 22 (n = 183; 47.8%), ST45 (n = 129; 33.7%), and ST239 (n = 26; 6.8%), with greater diversity of STs in ILTCFs relative to the ACH. A large proportion of the clades in ST22 (14 of 21 clades; 67%) and ST45 (7 of 13; 54%) included inpatients from the ACH and ILTCFs. The most frequent source of the interfacility transmissions was the ACH (n = 28 transmission events; 36.4%).Conclusions: MRSA transmission dynamics between the ACH and ILTCFs were complex. The greater diversity of STs in ILTCFs suggests that the ecosystem in such settings might be more conducive for intrafacility transmission events. ST22 and ST45 have successfully established themselves in ILTCFs. The importance of interconnected infection prevention and control measures and strategies cannot be overemphasized.

AB - Background: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common healthcare-associated multidrug-resistant organism. Despite the interconnectedness between acute care hospitals (ACHs) and intermediate- and long-term care facilities (ILTCFs), the transmission dynamics of MRSA between healthcare settings is not well understood.Methods: We conducted a cross-sectional study in a network comprising an ACH and 5 closely affiliated ILTCFs in Singapore. A total of 1700 inpatients were screened for MRSA over a 6-week period in 2014. MRSA isolates underwent whole-genome sequencing, with a pairwise single-nucleotide polymorphism (Hamming distance) cutoff of 60 core genome single-nucleotide polymorphisms used to define recent transmission clusters (clades) for the 3 major clones.Results: MRSA prevalence was significantly higher in intermediate-term (29.9%) and long-term (20.4%) care facilities than in the ACH (11.8%) (P < .001). The predominant clones were sequence type [ST] 22 (n = 183; 47.8%), ST45 (n = 129; 33.7%), and ST239 (n = 26; 6.8%), with greater diversity of STs in ILTCFs relative to the ACH. A large proportion of the clades in ST22 (14 of 21 clades; 67%) and ST45 (7 of 13; 54%) included inpatients from the ACH and ILTCFs. The most frequent source of the interfacility transmissions was the ACH (n = 28 transmission events; 36.4%).Conclusions: MRSA transmission dynamics between the ACH and ILTCFs were complex. The greater diversity of STs in ILTCFs suggests that the ecosystem in such settings might be more conducive for intrafacility transmission events. ST22 and ST45 have successfully established themselves in ILTCFs. The importance of interconnected infection prevention and control measures and strategies cannot be overemphasized.

KW - Whole-genome sequencing

KW - MRSA

KW - Transmission

KW - Intermediate-care facilities

KW - Long-term care facilities

UR - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cix072#80629288

U2 - 10.1093/cid/cix072

DO - 10.1093/cid/cix072

M3 - Article

VL - 64

SP - S76-S81

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - suppl_2

ER -

Related by author

  1. Genomic identification of cryptic susceptibility to penicillins and β-lactamase inhibitors in methicillin-resistant Staphylococcus aureus

    Harrison, E. M., Ba, X., Coll, F., Blane, B., Restif, O., Carvell, H., Köser, C. U., Jamrozy, D., Reuter, S., Lovering, A., Gleadall, N., Bellis, K. L., Uhlemann, A. C., Lowy, F. D., Massey, R. C., Grilo, I. R., Sobral, R., Larsen, J., Rhod Larsen, A., Vingsbo Lundberg, C. & 5 others, Parkhill, J., Paterson, G. K., Holden, M. T. G., Peacock, S. J. & Holmes, M. A., 24 Jun 2019, In : Nature Microbiology. 15 p.

    Research output: Contribution to journalArticle

  2. Atlas of group A streptococcal vaccine candidates compiled using large-scale comparative genomics

    Davies, M. R., McIntyre, L., Mutreja, A., Lacey, J. A., Lees, J. A., Towers, R. J., Duchêne, S., Smeesters, P. R., Frost, H. R., Price, D. J., Holden, M. T. G., David, S., Giffard, P. M., Worthing, K. A., Seale, A. C., Berkley, J. A., Harris, S. R., Rivera-Hernandez, T., Berking, O., Cork, A. J. & 18 others, Torres, R. S. L. A., Lithgow, T., Strugnell, R. A., Bergmann, R., Nitsche-Schmitz, P., Chhatwal, G. S., Bentley, S. D., Fraser, J. D., Moreland, N. J., Carapetis, J. R., Steer, A. C., Parkhill, J., Saul, A., Williamson, D. A., Currie, B. J., Tong, S. Y. C., Dougan, G. & Walker, M. J., Jun 2019, In : Nature Genetics. 51, 6, p. 1035-1043

    Research output: Contribution to journalArticle

  3. Antimicrobial resistance in atopic dermatitis: need for an urgent rethink

    Harkins, C. P., Holden, M. T. G. & Irvine, A. D., Mar 2019, In : Annals of Allergy Asthma & Immunology. 122, 3, p. 236-240 5 p.

    Research output: Contribution to journalArticle

  4. Molecular epidemiology and expression of capsular polysaccharides in Staphylococcus aureus clinical isolates in the United States

    Mohamed, N., Timofeyeva, Y., Jamrozy, D., Rojas, E., Hao, L., Silmon de Monerri, N. C., Hawkins, J., Singh, G., Cai, B., Liberator, P., Sebastian, S., Donald, R. G. K., Scully, I. L., Jones, C. H., Creech, C. B., Thomsen, I., Parkhill, J., Peacock, S. J., Jansen, K. U., Holden, M. T. G. & 1 others, Anderson, A. S., 14 Jan 2019, In : PLoS ONE. 14, 1, 33 p., e0208356.

    Research output: Contribution to journalArticle

Related by journal

  1. Late presentation with HIV in Africa: phenotypes, risk, and risk stratification in the REALITY trial

    Siika, A., McCabe, L., Bwakura-Dangarembizi, M., Kityo, C., Mallewa, J., Berkley, J., Maitland, K., Griffiths, A., Baleeta, K., Mudzingwa, S., Abach, J., Nathoo, K., Thomason, M. J., Prendergast, A. J., Walker, A. S., Gibb, D. M., Mugyenyi, P., Kityo, C., Musiime, V., Wavamunno, P. & 30 others, Nambi, E., Ocitti, P., Ndigendawani, M., Kemigisa, M., Acen, J., Olebo, D., Mpamize, G., Amone, A., Okweny, D., Mbonye, A., Nambaziira, F., Rweyora, A., Kangah, M., Kabaswahili, V., Abach, J., Abongomera, G., Omongin, J., Aciro, I., Philliam, A., Arach, B., Ocung, E., Amone, G., Miles, P., Adong, C., Tumsuiime, C., Kidega, P., Otto, B., Apio, F., Baleeta, K. & REALITY Trial Team, 1 Apr 2018, In : Clinical Infectious Diseases. 66, Issue suppl_2, p. S140-S146

    Research output: Contribution to journalArticle

  2. The potential for treatment shortening with higher rifampicin doses: relating drug exposure to treatment response in patients with pulmonary tuberculosis

    Svensson, E. M., Svensson, R. J., Te Brake, L. H. M., Boeree, M. J., Heinrich, N., Konsten, S., Churchyard, G., Dawson, R., Diacon, A. H., Kibiki, G. S., Minja, L. T., Ntingiya, N. E., Sanne, I., Gillespie, S. H., Hoelscher, M., Phillips, P. P. J., Simonsson, U. S. H. & Aarnoutse, R., 18 Jun 2018, In : Clinical Infectious Diseases. 67, 1, p. 34-41 8 p.

    Research output: Contribution to journalArticle

  3. 2015 epidemic of severe Streptococcus agalactiae sequence type 283 infections in Singapore associated with the consumption of raw freshwater fish: a detailed analysis of clinical, epidemiological, and bacterial sequencing data

    Kalimuddin, S., Chen, S. L., Lim, C. T. K., Koh, T. H., Tan, T. Y., Kam, M., Wong, C. W., Mehershahi, K. S., Chau, M. L., Ng, L. C., Tang, W. Y., Badaruddin, H., Teo, J., Apisarnthanarak, A., Suwantarat, N., Ip, M., Holden, M. T. G., Hsu, L. Y., Barkham, T. & Singapore Group B Streptococcus Consortium, 15 May 2017, In : Clinical Infectious Diseases. 64, suppl_2, p. S145-S152 8 p.

    Research output: Contribution to journalArticle

ID: 249970356

Top