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The molecular epidemiology and characteristics of methicillin resistant Staphylococcus aureus sequence type 22 in a local, national and international context.

Thomson, Calum Bryson (2017)
Ph.D. thesis, University of Birmingham.

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The globally distributed, ciprofloxacin resistant hospital associated methicillin resistant Staphylococcus aureus (MRSA) lineage epidemic (E)MRSA-15 (sequence type 22) continues to expand into new healthcare systems around the world. To further understand the evolution of EMRSA-15, which has been proposed to have emerged in the West Midlands, a large collection of contemporaneous and historical Birmingham isolates were studied alongside a collection of International genomes. Through generation of phylogentic trees this study has been able to determine that EMRSA-15 emerged in c1984 and that during this time a highly related healthcare associated ciprofloxacin sensitive ST22 population was present in Birmingham. A dominant, geographically restricted EMRSA-15 clone was also identified in Birmingham (designated the BHM clone). Analysis of the impact of fluoroquinolone use on the Birmingham EMRSA-15 phylogeny showed increasing use of fluoroquinolones (the introduction of ofloxacin) coincided with the emergence of the BHM clone. Further evidence of geographically restricted EMRSA-15 clones were found in Guernsey and Hong Kong; demonstrating localized evolution giving rise to distinct island populations. Comparison of the desiccation tolerance of geographically restricted and non-restricted EMRSA-15 clones indicated enhanced environmental survival as a possible reason for the spread and dominance of the restricted lineages.

Type of Work:Ph.D. thesis.
Supervisor(s):Hawkey, Peter and Hardy, Katie
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:Institute of Microbiology and Infection
Subjects:QR Microbiology
RA0421 Public health. Hygiene. Preventive Medicine
Institution:University of Birmingham
ID Code:7385
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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