Transmission and Microevolution of Methicillin-Resistant Staphylococcus aureus ST88 Strain Among Patients, Healthcare Workers, and Household Contacts at a Trauma and Orthopedic Ward

Staphylococcus aureus is a common pathogen that causes a wide range of clinical infections, which seriously endanger public health. Recently, because of increases in hypervirulent and low fitness-cost strains, community-acquired MRSA (CA-MRSA) clones are causing infections in hospitalized patients. However, the mode of nosocomial transmission of CA-MRSA has been rarely reported. Determining how MRSA spreads is a key factor in blocking its spread. This study investigated an MRSA infection outbreak in a trauma and orthopedic ward of a secondary hospital. The surgeon in charge of these patients and his son were found to be positive for MRSA colonization. Genomic surveillance data showed ST88 MRSA was transmitted among the patients, the surgeon and his son. We believed that our provided solid evidence from clinical cases that community-associated MRSA strains could invade hospitals and transmitted via household of healthcare worker. Importantly, next-generation sequencing technology is a useful tool for tracing MRSA strains causing severe outbreaks. Our results indicate that interventions, such as MRSA screening and decolonization, should not be limited to healthcare settings but also be implemented in the household environment.