Abstract
BackgroundResidents in nursing homes (NHs) always represent potential reservoirs for Staphylococcus aureus and methicillin-resistant S. aureus (MRSA). To our knowledge, there is no epidemiological information up till now that describes the prevalence and molecular characteristics of S. aureus in nursing home residents in Shanghai, China.MethodsFour hundred and ninety-one unique residents from 7 NHs were enrolled in this study. Specimens were collected among these residents including 491 nasal swabs, 487 axillary swabs and 119 skin swabs. S. aureus isolated and identified from the swabs was characterized according to antimicrobial susceptibility profiling, toxin gene prevalence, and multilocus sequence typing (MLST), spa and SCCmec typing.ResultsAmong the 491 residents screened, S. aureus was isolated in 109 residents from 90 nasal swabs (90/491, 18.3%), 29 axillary swabs (29/487, 6.0%), and 22 skin swabs (22/119, 18.5%). Sixty-eight MRSA isolates were detected in 52 residents from 41 nasal carriers, 15 axillary carriers and 12 skin carriers. The overall prevalence rate of S. aureus and MRSA colonization was 22.2% and 10.6% respectively. Ten residents presented S. aureus in all three sample types and 12 residents presented S. aureus in two of the three sample types collected. Molecular analysis revealed CC1 (29.1%) to be the dominant clone in this study, followed by CC398 (19.9%), CC188 (13.5%) and CC5 (12.8%). The most common spa type was t127 (22.0%), followed by t14383 (12.8%) and t002 (10.6%).ConclusionsA high prevalence of S. aureus and MRSA colonization was revealed in nursing home residents in Shanghai. CC1 was the most common clonal complex and t127 was the most common spa type among NH residents. The data provides an important baseline for future surveillance of S. aureus in NHs in Shanghai and other highly urbanized regions in China. Implementation of infection control strategies must be given high priority in NHs to fight such high prevalence of both MRSA and methicillin-susceptible S. aureus (MSSA).
Highlights
Staphylococcus aureus is a major pathogen which causes a wide range of human infectious diseases
A high prevalence of S. aureus and methicillin-resistant S. aureus (MRSA) colonization was revealed in nursing home residents in Shanghai
The data provides an important baseline for future surveillance of S. aureus in nursing homes (NHs) in Shanghai and other highly urbanized regions in China
Summary
Staphylococcus aureus is a major pathogen which causes a wide range of human infectious diseases. In the past several years, methicillin-resistant S. aureus (MRSA) has increased in incidence in many parts of the world as agents of nosocomial infections [1]. S. aureus and MRSA are major causes of morbidity and mortality worldwide and have leaded significant social and economic consequences [2]. Elderly people who reside in nursing homes (NHs) for long-term care represent an important reservoir for S. aureus and residence in a NH is a well-established risk factor for S. aureus carriage and infection[4]. A study has shown that there might be a substantial increase in incidence of S. aureus bacteremia over a 7-year period in NHs due almost exclusively to an increased occurrence of MRSA colonization [6]. Residents in nursing homes (NHs) always represent potential reservoirs for Staphylococcus aureus and methicillin-resistant S. aureus (MRSA). There is no epidemiological information up till that describes the prevalence and molecular characteristics of S. aureus in nursing home residents in Shanghai, China
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