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dc.contributor.authorHolden, Matthew Thomas Geoffrey
dc.contributor.authorHsu, Li-Yang
dc.contributor.authorKurt, Kevin
dc.contributor.authorWeinert, Lucy A.
dc.contributor.authorMather, Alison E.
dc.contributor.authorHarris, Simon R.
dc.contributor.authorStrommenger, Birgit
dc.contributor.authorLayer, Franziska
dc.contributor.authorWitte, Wolfgang
dc.contributor.authorde Lencastre, Herminia
dc.contributor.authorSkov, Robert
dc.contributor.authorWesth, Henrik
dc.contributor.authorZemlickova, Helena
dc.contributor.authorCoombs, Geoffrey
dc.contributor.authorKearns, Angela M.
dc.contributor.authorHill, Robert L. R.
dc.contributor.authorEdgeworth, Jonathan
dc.contributor.authorGould, Ian
dc.contributor.authorGant, Vanya
dc.contributor.authorCooke, Jonathan
dc.contributor.authorEdwards, Giles F.
dc.contributor.authorMcAdam, Paul R.
dc.contributor.authorTempleton, Kate E.
dc.contributor.authorMcCann, Angela
dc.contributor.authorZhou, Zhemin
dc.contributor.authorCastillo-Ramirez, Santiago
dc.contributor.authorFeil, Edward J.
dc.contributor.authorHudson, Lyndsey O.
dc.contributor.authorEnright, Mark C.
dc.contributor.authorBalloux, Francois
dc.contributor.authorAanensen, David M.
dc.contributor.authorSpratt, Brian G.
dc.contributor.authorFitzgerald, J. Ross
dc.contributor.authorParkhill, Julian
dc.contributor.authorAchtman, Mark
dc.contributor.authorBentley, Stephen D.
dc.contributor.authorNuebel, Ulrich
dc.identifier.citationHolden , M T G , Hsu , L-Y , Kurt , K , Weinert , L A , Mather , A E , Harris , S R , Strommenger , B , Layer , F , Witte , W , de Lencastre , H , Skov , R , Westh , H , Zemlickova , H , Coombs , G , Kearns , A M , Hill , R L R , Edgeworth , J , Gould , I , Gant , V , Cooke , J , Edwards , G F , McAdam , P R , Templeton , K E , McCann , A , Zhou , Z , Castillo-Ramirez , S , Feil , E J , Hudson , L O , Enright , M C , Balloux , F , Aanensen , D M , Spratt , B G , Fitzgerald , J R , Parkhill , J , Achtman , M , Bentley , S D & Nuebel , U 2013 , ' A genomic portrait of the emergence, evolution, and global spread of a methicillin-resistant Staphylococcus aureus pandemic ' Genome Research , vol. 23 , no. 4 , pp. 653-664 .
dc.identifier.otherPURE: 74259325
dc.identifier.otherPURE UUID: 02ea38c2-5ac9-402f-b97a-2fdde3aaac2d
dc.identifier.otherWOS: 000316920500007
dc.identifier.otherScopus: 84875741847
dc.identifier.otherORCID: /0000-0002-4958-2166/work/60196390
dc.description.abstractThe widespread use of antibiotics in association with high-density clinical care has driven the emergence of drug-resistant bacteria that are adapted to thrive in hospitalized patients. Of particular concern are globally disseminated methicillin-resistant Staphylococcus aureus (MRSA) clones that cause outbreaks and epidemics associated with health care. The most rapidly spreading and tenacious health-care-associated clone in Europe currently is EMRSA-15, which was first detected in the UK in the early 1990s and subsequently spread throughout Europe and beyond. Using phylogenomic methods to analyze the genome sequences for 193 S. aureus isolates, we were able to show that the current pandemic population of EMRSA-15 descends from a health-care-associated MRSA epidemic that spread throughout England in the 1980s, which had itself previously emerged from a primarily community-associated methicillin-sensitive population. The emergence of fluoroquinolone resistance in this EMRSA-15 subclone in the English Midlands during the mid-1980s appears to have played a key role in triggering pandemic spread, and occurred shortly after the first clinical trials of this drug. Genome-based coalescence analysis estimated that the population of this subclone over the last 20 yr has grown four times faster than its progenitor. Using comparative genomic analysis we identified the molecular genetic basis of 99.8% of the antimicrobial resistance phenotypes of the isolates, highlighting the potential of pathogen genome sequencing as a diagnostic tool. We document the genetic changes associated with adaptation to the hospital environment and with increasing drug resistance over time, and how MRSA evolution likely has been influenced by country-specific drug use regimens.
dc.relation.ispartofGenome Researchen
dc.rights© 2013, Published by Cold Spring Harbor Laboratory Press. This article is distributed exclusively by Cold Spring Harbor Laboratory Press for the first six months after the full-issue publication date (see After six months, it is available under a Creative Commons License (Attribution-NonCommercial 3.0 Unported License), as described at
dc.subjectFibronectin-binding proteinsen
dc.subjectValentine leucocidin geneen
dc.subjectAntimicrobial resistanceen
dc.subjectTrimethoprim resistanceen
dc.subjectFusidic aciden
dc.subjectFNB genesen
dc.subjectQH426 Geneticsen
dc.subjectRS Pharmacy and materia medicaen
dc.titleA genomic portrait of the emergence, evolution, and global spread of a methicillin-resistant Staphylococcus aureus pandemicen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews.School of Medicineen
dc.contributor.institutionUniversity of St Andrews.Infection Groupen
dc.contributor.institutionUniversity of St Andrews.Biomedical Sciences Research Complexen
dc.description.statusPeer revieweden

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