Differences in Staphylococcus aureus nasal carriage and molecular characteristics among community residents and healthcare workers at Sun Yat-Sen University, Guangzhou, Southern China.

Baiji Chen,Bo He,Yunwen Bao,Yandan Yao,Kunyi Pan,Xiquan Wu,Xinlu Dai,Hongyu Li,Weisi Lao,Xiaoqiang Liu,Songyin Huang

doi:10.1186/s12879-015-1032-7

Baiji Chen, Bo He + Show 9 more

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https://doi.org/10.1186/s12879-015-1032-7

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Abstract

BackgroundThe pathogenic potential and commensal nature of Staphylococcus aureus allows for easy transmission both within and outside of the hospital environment, and nasal carriage may be responsible for some serious infections. This study aimed to determine the molecular and epidemiological characteristics of nasal colonization by S. aureus in community residents (CR) and healthcare workers (HW) at Sun Yat-Sen University, Guangzhou, China.MethodsA total of 589 volunteers, both CR (n = 297) and HW (n = 292), were recruited. Each subject completed a questionnaire, and specimens were obtained from the anterior nares for S. aureus screening. Genotypic analysis included pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), staphylococcal cassette chromosome mec (SCCmec) typing, and virulence gene detection.ResultsA total of 138 S. aureus isolates were recovered from separate subjects (23.4 %, 138/589), with four isolates showing methicillin resistance (0.7 %, 4/589). The prevalence of S. aureus carriage was 25.3 % (75/297) in CR and 21.6 % (63/292) in HW. Methicillin-resistant S. aureus (MRSA) were isolated from one CR (0.3 %, 1/297) and three HW (1.0 %, 3/292). The most common risk factors for S. aureus carriage in CR were being male, age ≤ 30 years, and nasal cavity cleaning habits. Having a household member in the healthcare profession was associated with increased risk among HW. Sequence type (ST)188 and ST59 were the most prevalent among the 20 observed STs, accounting for 14.6 % and 12.2 % of all isolates, respectively. The four MRSA isolates presented four different STs, with one isolate carrying a type IVa SCCmec element and the other three isolates containing type III SCCmec. PFGE analysis grouped the 129 isolates into 23 pulsotypes, with profiles A, N, E, L, and O the most prevalent. The Panton-Valentine leucocidin gene (pvl) was identified in two of the 138 isolates, while 57.5 % of isolates carried both the Staphylococcus aureus enterotoxin A (sea) and enterotoxin B (seb) genes.ConclusionsThese data indicate a low prevalence of nasal MRSA carriage but evidence of molecular heterogeneity among S. aureus isolates from CR and HW at Sun Yat-Sen University, Guangzhou. Differences in epidemiological and molecular characteristics of S. aureus between CR and HW populations may be useful for the understanding and prevention of S. aureus infection.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1032-7) contains supplementary material, which is available to authorized users.

Highlights

The pathogenic potential and commensal nature of Staphylococcus aureus allows for easy transmission both within and outside of the hospital environment, and nasal carriage may be responsible for some serious infections
Chen et al BMC Infectious Diseases (2015) 15:303 (Continued from previous page). These data indicate a low prevalence of nasal methicillin-resistant S. aureus (MRSA) carriage but evidence of molecular heterogeneity among S. aureus isolates from community residents (CR) and healthcare workers (HW) at Sun Yat-Sen University, Guangzhou
Differences in epidemiological and molecular characteristics of S. aureus between CR and HW populations may be useful for the understanding and prevention of S. aureus infection

Summary

Introduction

The pathogenic potential and commensal nature of Staphylococcus aureus allows for easy transmission both within and outside of the hospital environment, and nasal carriage may be responsible for some serious infections. This study aimed to determine the molecular and epidemiological characteristics of nasal colonization by S. aureus in community residents (CR) and healthcare workers (HW) at Sun Yat-Sen University, Guangzhou, China. Determination of the prevalence of S. aureus nasal carriage in healthy populations, as well as resistance gene profiling and molecular typing of nasal S. aureus isolates, is beneficial for identifying risk factors associated with S. aureus infection [5, 6]. Molecular epidemiological studies have shown that a limited number of methicillin-resistant S. aureus (MRSA) strains have spread by clonal dissemination between different hospitals, cities, countries, and even continents, and cause healthcare-associated MRSA (HA-MRSA) infections worldwide [7, 8]. Another study revealed a similar nasal carriage rate (16.5 %) and low prevalence of MRSA colonization (0.3 %) in 2448 healthy people from Beijing and Harbin [13]. A relatively high prevalence of MRSA colonization was found (11.6 %) in a cohort of healthy children aged ≤ 14 years in community settings in Taiwan over a 5-year period [14]

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