Tracing MRSA in Households With Patients Infected With CA-MRSA by WGS
Condition: MRSA
Study type: Observational

Summary: 
      From the 1980s to the late 1990s, highly toxic methicillin-resistant Staphylococcus aureus
      (MRSA) strains (called community-associated [CA] MRSA) appeared in the community. Although
      the prevalence of HA-MRSA (health-related MRSA) infection remained stable between 1998 and
      2008, the CA-MRSA (community-related MRSA) infection rate increased. By far, the most common
      manifestations of CA-MRSA related diseases are skin and soft tissue infections. Skin and soft
      tissue infections (SSTIs) account for at least 90% of CA-MRSA infections. CA-MRSA strains
      also cause bone and joint infections, such as osteomyelitis and respiratory infections, such
      as pneumonia, sepsis, and urinary tract infections. Given that Staphylococcus aureus can live
      in the home as a settler or environmental pollutant, the environment can be used as a medium
      for obtaining and transmitting MRSA. In addition, transmission of MRSA between pets and
      humans has been proposed, but the directionality is unclear. In this study, we report an
      in-depth epidemiological and genomics study of a community-associated methicillin-resistant
      Staphylococcus aureus infection in SSRSH, Zhejiang Province, China.
    

Detailed description: 
      Eligibility criteria:

        1. Inclusion criteria: Patients (Child, Adult) with infections caused by S. aureus from the
           sites as follows: blood stream, skin or soft tissue, cerebrospinal fluid, bone and
           joint, genitourinary tract, infection of indwelling intravascular device, surgical
           wound, respiratory tract (organism grown from sputum and infiltrate on chest X-ray),
           peritoneal fluid or other otherwise sterile body fluids.

        2. Exclusion criteria: Patients with risk factors for nosocomial or medically related
           infections, and patients who have been decolonized (using mupirocin, chlorhexidine or
           bleach) in the past month.

      Outcome measures:

        1. Isolation rate of staphylococcus aureus and methicillin-resistant staphylococcus aureus
           on domestic environment, contact and pets and livestock.

        2. Molecular characteristics of CA-MRSA isolates recovered in Chinese hospitals, home
           environments, contacts, and pets and livestock.

      Definition:

      A MRSA infection was considered to be HA-MRSA by the CDC epidemiologic definitions if, in the
      year prior to culture, the subject had surgery, hospitalization, hemodialysis or a stay in a
      long-term care facility, if an indwelling vascular catheter was in place at the time of
      culture, or if the subject was an inpatient hospitalized for 2 days at the time of culture.
      Otherwise, the subject was considered to have a CA-MRSA infection.
    

Intervention name(s): none intervention
Intervention type(s): Other
Observational model: Family-Based
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        No special requirements
      
Keywords: MRSA; Whole-genome sequencing