Tracing MRSA in Households With Patients Infected With CA-MRSA by WGS

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.

Study Overview

• Status: Completed
• Conditions: MRSA
• Intervention / Treatment: Other: none intervention

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.

• Study Type: Observational
• Enrollment (Actual): 10

Contacts and Locations

Study Locations

• China
  • Zhejiang
    • Hanzhou, Zhejiang, China, 310016
      • Sir Run Run Shaw Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

No special requirements

Description

Inclusion Criteria:

• Patients (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.

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.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patients infected with CA-MRSA; It is an observational study, no interventions to any of the two study arms.	Other: none intervention
Healthy people without any infection; It is an observational study, no interventions to any of the two study arms.	Other: none intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Clonal Distribution of CA-MRSA in China The distribution of sequence types in CA-MRSA isolates from China	During the study period (One years)

Collaborators and Investigators

• Sponsor: Sir Run Run Shaw Hospital
• Investigators: Principal Investigator: Yun-song Yu, MD, Sir Run Run Shaw Hospital

Study record dates

Study Major Dates

• Study Start (Actual): November 15, 2019
• Primary Completion (Actual): March 17, 2020
• Study Completion (Actual): March 17, 2020

Study Registration Dates

• First Submitted: March 16, 2020
• First Submitted That Met QC Criteria: March 16, 2020
• First Posted (Actual): March 18, 2020

Study Record Updates

• Last Update Posted (Actual): March 18, 2020
• Last Update Submitted That Met QC Criteria: March 16, 2020
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Keywords: MRSA; Whole-genome sequencing
• Other Study ID Numbers: SRRSH-Household01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No