Abstract
Staphylococcus aureus is one of the most important human pathogens and meticillin-resistant S. aureus (MRSA) presents a major cause of healthcare- and community-acquired infections. This study investigated the spatial and temporal changes of S. aureus causing bacteraemia in Europe over a five-year interval and explored the possibility of integrating pathogen-based typing data with epidemiological and clinical information at a European level. Between January 2011 and July 2011, 350 laboratories serving 453 hospitals in 25 countries collected 3,753 isolates (meticillin-sensitive S. aureus (MSSA) and MRSA) from patients with S. aureus bloodstream infections. All isolates were sent to the national staphylococcal reference laboratories and characterised by quality-controlled spa typing. Data were uploaded to an interactive web-based mapping tool. A wide geographical distribution of spa types was found, with some prevalent in all European countries. MSSA was more diverse than MRSA. MRSA differed considerably between countries with major international clones expanding or receding when compared to a 2006 survey. We provide evidence that a network approach of decentralised typing and visualisation of aggregated data using an interactive mapping tool can provide important information on the dynamics of S. aureus populations such as early signalling of emerging strains, cross-border spread and importation by travel.
Highlights
Staphylococcus aureus is one of the major causes of bacterial infection in humans [1]
We addressed a request from the European Centre for Disease Prevention and Control (ECDC) to explore the usefulness of integration of molecular typing data with epidemiological and clinical data at a European level
For the United Kingdom, Scotland participated on its own behalf, whereas
Summary
Staphylococcus aureus is one of the major causes of bacterial infection in humans [1]. Infections occur in the community or in healthcare settings, predominantly following acquisition from mainly human sources. Meticillin-resistant S. aureus (MRSA) are predominantly acquired in healthcare settings and represent a major challenge to the control of antibiotic resistance in hospitals. MRSA has become the currency with which the success of infection control initiatives is measured at health systems level [2]. S. aureus can acquire particular virulence traits and has been responsible for major outbreaks of toxinmediated disease in the community [3]. S. aureus evolves gradually by successive acquisition of syntenic changes of largely unaltered core genomes.
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