Abstract
Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) can acquire phage-encoded immune modulators, such as the immune evasion cluster (IEC), which protects bacteria from components of the human innate immune system, and the enzyme TarP, which protects against antibody-mediated immune recognition. We used whole-genome sequencing and epidemiologic investigations to study the effects of IEC- and tarP-harboring phages on household transmission of LA-MRSA in North Denmark Region during 2004-2011. We reviewed information about all patients throughout Denmark who experienced LA-MRSA infection during 2007-2018 to determine whether IEC is associated with increased spread into the general population. Horizontal acquisition of IEC in the human host was associated with increased household transmission of LA-MRSA and spillover into the community and healthcare settings, whereas we found no evidence to suggest that IEC-positive LA-MRSA isolates have become self-sustainable in the general population. By contrast, TarP did not seem to influence household transmission of LA-MRSA.
Highlights
Medscape, LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM
Distribution of immune evasion cluster (IEC) and tarP in Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) CC398 Most of the human isolates collected from persons living in the same household clustered together, with an average pairwise single-nucleotide polymorphism (SNP) distance of 5.9 and were genotypically homogeneous with respect to presence of specific IEC-harboring and tarP-harboring prophages (Appendix 2 Figure)
Prevalence of IEC among LA-MRSA CC398 Isolates in Persons with No Livestock Contact We investigated whether IEC plays a role during spread of LA-MRSA CC398 in the general population, on the assumption that persons with direct livestock contact serve as the source of transmission to their household contacts and into the local community, through which the bacterium is transmitted into healthcare settings
Summary
LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Determine the association of IEC- and tarP-harboring phages in LA-MRSA in the North Denmark Region during 2004–2011 with spread in the general population, according to an analysis of all Danish patients who had an episode of LA-MRSA infection during 2007–2018
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