Phylodynamic signatures in the emergence of community-associated MRSA

Eike Steinig, Izzard Aglua, Sebastian Duchene, Michael T. Meehan, Mition Yoannes, Cadhla Firth, Jan Jaworski, Jimmy Drekore, Bohu Urakoko, Harry Poka, Clive Wurr, Eri Ebos, David Nangen, Elke Müller, Peter Mulvey, Charlene Jackson, Anita Blomfeldt, Hege Vangstein Aamot, Moses Laman, Laurens ManningMegan Earls, David C. Coleman, Andrew Greenhill, Rebecca Ford, Marc Stegger, Muhammad Ali Syed, Bushra Jamil, Stefan Monecke, Ralf Ehricht, Simon Smith, William Pomat, Paul Horwood, Steven Y.C. Tong, Emma McBryde

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Community-associated, methicillin-resistant Staphylococcus aureus (MRSA) lineages have emerged in many geographically distinct regions around the world during the past 30 y. Here, we apply consistent phylodynamic methods across multiple community-associated MRSA lineages to describe and contrast their patterns of emergence and dissemination. We generated whole-genome sequencing data for the Australian sequence type (ST) ST93-MRSA-IV from remote communities in Far North Queensland and Papua New Guinea, and the Bengal Bay ST772-MRSA-V clone from metropolitan communities in Pakistan. Increases in the effective reproduction number (Re) and sustained transmission (Re > 1) coincided with spread of progenitor methicillin-susceptible S. aureus (MSSA) in remote northern Australian populations, dissemination of the ST93-MRSA-IV genotype into population centers on the Australian East Coast, and subsequent importation into the highlands of Papua New Guinea and Far North Queensland. Applying the same phylodynamic methods to existing lineage datasets, we identified common signatures of epidemic growth in the emergence and epidemiological trajectory of community-associated S. aureus lineages from America, Asia, Australasia, and Europe. Surges in Re were observed at the divergence of antibiotic-resistant strains, coinciding with their establishment in regional population centers. Epidemic growth was also observed among drug-resistant MSSA clades in Africa and northern Australia. Our data suggest that the emergence of community-associated MRSA in the late 20th century was driven by a combination of antibiotic-resistant genotypes and host epidemiology, leading to abrupt changes in lineage-wide transmission dynamics and sustained transmission in regional population centers.

Original languageEnglish
Article numbere2204993119
Pages (from-to)e2204993119
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number45
Publication statusPublished - 8 Nov 2022


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