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Rosales-González NC, González-Martín M, Abdullahi IN, Tejedor-Junco MT, Latorre-Fernández J, Torres C. Prevalence, antimicrobial resistance, and genetic lineages of nasal Staphylococcus aureus among medical students at a Spanish University: detection of the MSSA-CC398-IEC-type-C subclade. Res Microbiol 2024; 175:104176. [PMID: 38141795 DOI: 10.1016/j.resmic.2023.104176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
Medical students could be a potential source of Staphylococcus aureus transmission to patients. This cross-sectional study involved samples collected from both nasal nostrils. Samples were processed for S. aureus recovery; the antimicrobial resistance (AMR) phenotype was determined by disc diffusion assays and the spa types and AMR genotypes by PCR/sequencing. A structured questionnaire was administered to students to collate data related to potential risk factors of nasal colonization. Ninety-eight students were included, 50 % were colonized by S. aureus and 12.2 % by MRSA. The mecA gene was detected in all MRSA isolates. The MSSA-CC398-IEC-type C lineage was found among 16.3 % of nasal carriers, of which t571 was the predominant spa-type. MRSA isolates were ascribed to spa types t2226 (CC5, 12 isolates) and t3444 (new spa type, 1 isolate). All MRSA were multi-drug resistant and MSSA were predominantly resistant to erythromycin-clindamycin (inducible-type, mediated by ermT gene). High rates of S. aureus and MRSA nasal carriages were observed in this study. The predominance of the CC398 lineage among MSSA (emergent invasive lineage) represent a relevant finding of public health concern. The role of medical students as potential source of MRSA and MSSA-CC398 transmissions in hospital and community needs to be elucidated in detail.
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Affiliation(s)
| | - Margarita González-Martín
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.
| | - Idris Nasir Abdullahi
- Area of Biochemistry and Molecular Biology, One Health-UR Research Group, University of La Rioja, 26006 Logroño, Spain
| | - María Teresa Tejedor-Junco
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Javier Latorre-Fernández
- Area of Biochemistry and Molecular Biology, One Health-UR Research Group, University of La Rioja, 26006 Logroño, Spain
| | - Carmen Torres
- Area of Biochemistry and Molecular Biology, One Health-UR Research Group, University of La Rioja, 26006 Logroño, Spain
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Pongbangli N, Oniem N, Chaiwarith R, Nantsupawat T, Phrommintikul A, Wongcharoen W. Prevalence of Staphylococcus aureus nasal carriage and surgical site infection rate among patients undergoing elective cardiac surgery. Int J Infect Dis 2021; 106:409-414. [PMID: 33737131 DOI: 10.1016/j.ijid.2021.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Nasal carriers of Staphylococcus aureus are at increased risk of postoperative surgical site infection. Nasal decolonization with mupirocin is recommended in patients undergoing cardiac surgery to reduce surgical site infection. These data are still lacking in Thailand. Therefore, the aim of this study was to determine the prevalence of S. aureus nasal carriage in Thai patients undergoing elective cardiac surgery. The association of surgical site infection and S. aureus nasal carriage was also examined. METHODS This was a prospective cohort study of 352 patients who planned to undergo elective cardiac surgery. Nasal swab culture was performed in all patients preoperatively. RESULTS Of 352 patients, 46 (13.1%) had a positive nasal swab culture for methicillin-sensitive S. aureus (MSSA) and one patient (0.3%) harbored a methicillin-resistant S. aureus (MRSA) strain. The incidence of superficial and deep surgical site infection was 1.3% and 0.3%, respectively. After multivariate analysis, S. aureus nasal carriage was independently associated with superficial surgical site infection (odds ratio 13.04, 95% confidence interval 1.28-133.27; P=0.03). CONCLUSIONS The prevalence of MSSA and MRSA nasal carriage in Thai patients undergoing elective cardiac surgery was low. The incidence of surgical site infection was also very low in the population studied. Nevertheless, it was found that S. aureus nasal carriage increased the risk of superficial surgical site infection.
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Affiliation(s)
- Natnicha Pongbangli
- Division of Cardiology, Department of Internal Medicine, Chiang-Rai Prachanukroh Hospital, Chiang-Rai, Thailand
| | - Noparat Oniem
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Romanee Chaiwarith
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Teerapat Nantsupawat
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Arintaya Phrommintikul
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wanwarang Wongcharoen
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Chen KH, Chuang WC, Wong WK, Chuang CH, Chen CJ, Huang YC. Nasal Methicillin-Resistant Staphylococcus aureus Carriage Among Foreign Workers Recruited to Taiwan From Southeastern Asian Countries. Open Forum Infect Dis 2020; 8:ofaa586. [PMID: 33511227 PMCID: PMC7814388 DOI: 10.1093/ofid/ofaa586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/03/2020] [Indexed: 11/14/2022] Open
Abstract
Background In 2012, we identified the dissemination of methicillin-resistant Staphylococcus aureus (MRSA) sequence type (ST)45 strain in 14 nursing homes in Taiwan and foreign nurse workers, a significant risk factor for MRSA carriage. We conducted this study to understand MRSA carriage and molecular characteristics among foreign workers recruited from Southeastern Asian countries. Methods A cross-sectional study involving a total of 1935 foreign workers—929 (arrival group) and 1006 (staying group)—from Vietnam (n = 843), Indonesia (n = 780), the Philippines (n = 239), and Thailand (n = 70) were conveniently recruited during upon-arrival and regular health examination in a regional hospital. A nasal swab was obtained from each participant for detection of MRSA. Results Overall, MRSA carriage rate was 2.72%, with 2.26% for arrival group and 3.18% for staying group, and 4.74% for Vietnamese, 1.28% for Indonesians, 1.26% for Filipino, and none for Thai workers. Pulsotype AK/ST45 (57%) and pulsotype AX/ST188 (14%) were the top 2 dominant clones for the arrival group, whereas pulsotype D/ST59 (41%) (an endemic community clone in Taiwan) and pulsotype AK/ST45 (19%) were predominant for the staying group. A significant decrease of pulsotype AK/ST45 from 57% to 19% (P = .007) and increase of pulsotype D/ST59 from 4.8% to 41% (P = .004) were found between the arrival and the staying groups. Conclusions Approximately 3% of foreign workers recruited from Southeastern Asian countries to Taiwan were colonized with MRSA, including the ST45 strain. However, the MRSA isolates from workers staying in Taiwan were mostly a locally endemic clone and genetically different from those identified from workers on arrival.
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Affiliation(s)
- Kuan-Hung Chen
- Department of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Wen-Ching Chuang
- Department of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Wang-Kin Wong
- Department of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | | | - Chih-Jung Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yhu-Chering Huang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Correspondence: Yhu-C. Huang, MD, PhD, Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children’s Hospital, Chang Gung Memorial Hospital, Taoyuan, Taiwan, No. 5, Fu-Hsing Street, Kweishan, Taoyuan, Taiwan 333 ()
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Singh SR, Mao B, Evdokimov K, Tan P, Leab P, Ong R, Vonthanak S, Tam CC, Hsu LY, Turner P. Prevalence of MDR organism (MDRO) carriage in children and their household members in Siem Reap Province, Cambodia. JAC Antimicrob Resist 2020; 2:dlaa097. [PMID: 34223049 PMCID: PMC8210010 DOI: 10.1093/jacamr/dlaa097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The rising incidence of infections caused by MDR organisms (MDROs) poses a significant public health threat. However, little has been reported regarding community MDRO carriage in low- and middle-income countries. METHODS We conducted a cross-sectional study in Siem Reap, Cambodia comparing hospital-associated households, in which an index child (age: 2-14 years) had been hospitalized for at least 48 h in the preceding 2-4 weeks, with matched community households on the same street, in which no other child had a recent history of hospitalization. Participants were interviewed using a survey questionnaire and tested for carriage of MRSA, ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) by culture followed by antibiotic susceptibility testing. We used logistic regression analysis to analyse associations between collected variables and MDRO carriage. RESULTS Forty-two pairs of households including 376 participants with 376 nasal swabs and 290 stool specimens were included in final analysis. MRSA was isolated from 26 specimens (6.9%). ESBL-producing Escherichia coli was detected in 269 specimens (92.8%) whereas ESBL-producing Klebsiella pneumoniae was isolated from 128 specimens (44.1%), of which 123 (42.4%) were co-colonized with ESBL-producing E. coli. Six (2.1%) specimens tested positive for CPE (4 E. coli and 2 K. pneumoniae). The prevalence ratios for MRSA, ESBL-producing E. coli and ESBL-producing K. pneumoniae carriage did not differ significantly in hospital-associated households and hospitalized children compared with their counterparts. CONCLUSIONS The high prevalence of ESBL-E across both household types suggests that MDRO reservoirs are common in the community. Ongoing genomic analyses will help to understand the epidemiology and course of MDRO spread.
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Affiliation(s)
- Shweta R Singh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Bunsoth Mao
- University of Health Sciences, Phnom Penh, Cambodia
| | - Konstantin Evdokimov
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Pisey Tan
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Phana Leab
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Rick Ong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Clarence C Tam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Paul Turner
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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Huang YC, Su LH, Wu TL, Lin TY. Methicillin-resistant Staphylococcus aureus nasal carriage in international medical conference attendees. J Microbiol Immunol Infect 2019; 52:242-7. [PMID: 30181097 DOI: 10.1016/j.jmii.2018.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/15/2018] [Accepted: 08/17/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with its transmission. International travels and massive gatherings may accelerate such transmission. MRSA carriage was surveyed among the attendees of two international medical conferences held in Taipei in 2010. METHODS A total of 209 attendees from 23 countries were recruited. Nasal specimens were collected from each volunteer and subjected to polymerase chain reaction (PCR) detection for MRSA. Molecular analysis, including pulsed-field gel electrophoresis, multilocus sequence typing (MLST), typing of staphylococcal cassette chromosome mec (SCCmec) and staphylococcal protein A (spa) genes, and detection of Panton-Valentine leukocidin (PVL) and sasX genes, was performed. RESULTS MRSA carriage was detected in 10 (4.8%) attendees from Vietnam (3/8, 37.5%), Korea (2/6, 33.3%), Japan (2/41, 4.9%), Philippines (2/52, 3.8%), and Bangladesh (1/4, 25.0%). The proportion of MRSA colonizers was significantly higher in the local hospital group compared to those from the other groups (3/17 vs. 7/192, p < 0.05). Six MRSA isolates were available for molecular analysis. They all carried a type IV SCCmec gene. Five pulsotypes were identified; four genotypes, respectively, were identified by MLST and spa typing. None of the isolates carried either PVL or sasX genes. None of common molecular characteristics was shared by isolates from different countries. Most of these isolates were local endemic community clone in each country. CONCLUSIONS As healthcare workers, a certain proportion of international medical conference attendees harbored MRSA in their nares, mostly local endemic community clones in each country, which has the potential of spread among attendees.
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Bhatta DR, Hamal D, Shrestha R, Parajuli R, Baral N, Subramanya SH, Nayak N, Gokhale S. Nasal and Pharyngeal Colonization by Bacterial Pathogens: A Comparative Study between Preclinical and Clinical Sciences Medical Students. Can J Infect Dis Med Microbiol 2018; 2018:7258672. [PMID: 29983836 DOI: 10.1155/2018/7258672] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 04/16/2018] [Accepted: 05/02/2018] [Indexed: 11/29/2022]
Abstract
Background Upper respiratory tract is one of the commonest sites for microbial colonization. The colonized individuals are at risk of infections and can be a source of transmission of pathogens. Medical students are frequently exposed to a variety of infectious agents and more likely to get colonized by them. This study was aimed to determine the prevalence and to compare the colonization rates of nasal and pharyngeal bacterial pathogens among preclinical and clinical sciences medical students. Methods This cross-sectional study was conducted among 100 preclinical and 100 clinical sciences medical students. Isolation, identification, and antibiotic susceptibility testing of the isolates were performed by standard microbiological techniques. Results The nasal colonization by S. aureus and MRSA was 35% (70/200) and 19.5% (39/200), respectively. The nasal colonization by S. aureus and MRSA was significantly higher among clinical sciences students as compared to preclinical sciences students. Pharyngeal colonization by Haemophilus influenzae was significantly higher among clinical sciences students as compared to preclinical sciences students. The pharyngeal colonization by beta-hemolytic streptococci (nongroup A) was higher among preclinical sciences students than clinical sciences students. Conclusion The nasal colonization by S. aureus and MRSA was higher among clinical sciences students. Pharyngeal colonization by potential bacterial pathogens was higher among clinical sciences students than preclinical students. Periodic screening of MRSA and potential throat pathogens of clinical sciences students and may reduce the incidences of nosocomial transmission of pathogens.
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Xie X, Dai X, Ni L, Chen B, Luo Z, Yao Y, Wu X, Li H, Huang S. Molecular epidemiology and virulence characteristics of Staphylococcus aureus nasal colonization in medical laboratory staff: comparison between microbiological and non-microbiological laboratories. BMC Infect Dis 2018. [PMID: 29529992 PMCID: PMC5848597 DOI: 10.1186/s12879-018-3024-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background Medical laboratory staff are a high-risk population for colonization of Staphylococcus aureus (S. aureus) due to direct and dense contact with the pathogens; however, there is limited information about this colonization. This study sought to determine the prevalence and molecular characteristics of nasal colonization by S. aureus in medical laboratory staff in Guangzhou, southern China, and to compare the differences between microbiological laboratory (MLS) and non-microbiological laboratory (NMLS) staff. Methods S. aureus colonization was assessed by nasal swab cultures from 434 subjects, including 130 MLSs and 304 NMLSs from 33 hospitals in Guangzhou. All S. aureus isolates underwent the antimicrobial susceptibility test, virulence gene detection and molecular typing. Results The overall prevalence of S. aureus carriage was 20.1% (87/434), which was higher in MLSs than in NMLSs (26.2% vs. 17.4%, P < 0.05), while the prevalence of Methicillin-resistant S. aureus (MRSA) was similar. Living with hospital staff was associated with S. aureus carriage. The majority of the isolates harboured various virulence genes, and those in MLSs appeared less resistant to antibiotics and more virulent than their counterparts. A total of 37 different spa types were detected; among these, t338, t437, t189 and t701 were the most frequently encountered types. T338 was the main spa type contributing to nasal colonization Methicillin-sensitive S. aureus (MSSA) (13.0%), and t437-SCCmec IV was predominant in MRSA isolates (40%). Conclusions These findings provide insight into the risk factors, molecular epidemiology and virulence gene profiles of S. aureus nasal carriage among the medical laboratory staff in Guangzhou. Electronic supplementary material The online version of this article (10.1186/s12879-018-3024-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaoying Xie
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Xinlu Dai
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Lijia Ni
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Baiji Chen
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Zhaofan Luo
- Department of Clinical Laboratory, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518071, China
| | - Yandan Yao
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Xiquan Wu
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Hongyu Li
- Department of Clinical Laboratory, Zengcheng District People Hospital of Guangzhou, Guangzhou, 511300, China. .,Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Songyin Huang
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China. .,Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
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Kwiatkowski P, Mnichowska-Polanowska M, Pruss A, Masiuk H, Dzięcioł M, Giedrys-Kalemba S, Sienkiewicz M. The effect of fennel essential oil in combination with antibiotics on Staphylococcus aureus strains isolated from carriers. Burns 2017; 43:1544-1551. [PMID: 28917968 DOI: 10.1016/j.burns.2017.04.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/26/2017] [Accepted: 04/11/2017] [Indexed: 11/17/2022]
Abstract
An increase in the number of staphylococcal infections and carriers among medical staff has forced us to seek more and more effective antibacterial agents. Bacteria from the Staphylococcus genus possessing different mechanisms of resistance are the cause of nosocomial infections. The objective of our investigations was susceptibility of S. aureus strains isolated from nasal vestibule of medical students to fennel essential oil. The GC-MS analysis of fennel essential oil revealed eleven constituents among which a majority of trans-anethole (80%) was found. The D-tests showed iMLSB (80%), cMLSB and MSB (10%) resistant phenotypes of S. aureus. The S. aureus isolates were intermediate to mupirocin (45%). Fennel essential oil increased the inhibition zone around cefoxitin, mupirocin, co-trimoxazole and ciprofloxacin with statistical significance. Our research showed that the fennel essential oil in combination with mupirocin may be considered as a natural alternative in eradication of S. aureus with iMLSB, cMLSB, MSB resistant phenotypes and is able to decrease the growth rate of antibiotic resistance.
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Affiliation(s)
- Paweł Kwiatkowski
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University in Szczecin, Poland.
| | | | - Agata Pruss
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University in Szczecin, Poland
| | - Helena Masiuk
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University in Szczecin, Poland
| | - Małgorzata Dzięcioł
- Faculty of Chemical Technology and Engineering, West Pomeranian University of Technology, Szczecin, Poland
| | | | - Monika Sienkiewicz
- Department of Allergology and Respiratory Rehabilitation, 2nd Chair of Otolaryngology, Medical University of Lodz, Poland
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Orlin I, Rokney A, Onn A, Glikman D, Peretz A. Hospital clones of methicillin-resistant Staphylococcus aureus are carried by medical students even before healthcare exposure. Antimicrob Resist Infect Control 2017; 6:15. [PMID: 28138384 PMCID: PMC5260124 DOI: 10.1186/s13756-017-0175-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/12/2017] [Indexed: 11/15/2022] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) strains are prevalent in healthcare and the community. Few studies have examined MRSA carriage among medical students. The aim of this study is to examine Staphylococcus aureus (SA) carriage, and particular MRSA, over time in cohort medical students Methods Prospective collection of nasal swabs from medical students in Israel and assessment of SA carriage. Three samples were taken per student in preclinical and clinical parts of studies. Antibiotic susceptibilities were recorded and MRSA typing was performed by staphylococcal cassette chromosome mec (SCCmec) types, Panton Valentine Leukocidin (PVL) encoding genes, and spa types. Clonality was assessed by pulsed-field gel electrophoresis. Results Among 58 students, SA carriage rates increased from 33% to 38% to 41% at baseline (preclinical studies), 13 and 19 months (clinical studies), respectively (p = 0.07). Methicillin-susceptible SA (MSSA) carriage increased in the clinical studies period (22 to 41%, p = 0.01). Overall, seven students (12%) carried 13 MRSA isolates. MRSA isolates were PVL negative and were characterized as SCCmecII-t002, SCCmecIV-t032, or t12435 with untypable SCCmec. MRSA carriage during the pre-clinical studies was evident in 4/7 students. Two students carried different MRSA clones at various times and persistent MRSA carriage was noted in one student. Simultaneous carriage of MRSA and MSSA was not detected. Conclusions MSSA carriage increased during the clinical part of studies in Israeli medical students. Compared with previous reports, higher rates of MRSA carriage were evident. MRSA strains were genotypically similar to Israeli healthcare-associated clones; however, carriage occurred largely before healthcare exposure, implying community-acquisition of hospital strains.
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Affiliation(s)
- Ido Orlin
- The Faculty of Medicine in the Galilee, Bar-Ilan University, Galilee, Israel
| | - Assaf Rokney
- National Staphylococcus aureus Reference Center, Central Laboratories, Israel Ministry of Health, Jerusalem, Israel
| | - Avi Onn
- The Faculty of Medicine in the Galilee, Bar-Ilan University, Galilee, Israel.,Pediatric Gastrointestinal Unit, Padeh Poriya Medical Center, Poriya, Tiberias Israel
| | - Daniel Glikman
- The Faculty of Medicine in the Galilee, Bar-Ilan University, Galilee, Israel.,Pediatric Infectious Diseases Service, Galilee Medical Center, Nahariya, Israel
| | - Avi Peretz
- The Faculty of Medicine in the Galilee, Bar-Ilan University, Galilee, Israel.,Clinical Microbiology Laboratory, Padeh Poriya Medical Center, Poriya, Hanna Senesh 818/2, Tiberias, Israel
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Petti S, Kakisina N, Volgenant CM, Messano GA, Barbato E, Passariello C, de Soet JJ. Low methicillin-resistant Staphylococcus aureus carriage rate among Italian dental students. Am J Infect Control 2015; 43:e89-91. [PMID: 26384585 DOI: 10.1016/j.ajic.2015.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/09/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022]
Abstract
We assessed methicillin-resistant Staphylococcus aureus (MRSA) carriage rate among dental students from an Italian university. A total of 157 subjects participated (67 preclinical students and 90 clinical students); samples were collected from the nose, mouth, and skin. Five preclinical students and 0 clinical students were MRSA-positive. Carriage rates were 3.2% (95% confidence interval [CI], 0.4%-6.0%) overall, 7.5% (95% CI, 1.2%-13.8%) in preclinical students and 0% in clinical students. There were 2 MRSA clusters among the preclinical students: 3 second-year and 2 first-year students, who sat close to one another in the classroom the day of the sample. MRSA carriage was not associated with dental health care. The pooled carriage rate among dental students was assessed to obtain a reliable figure of carriage rate unaffected by local conditions. The 4 published surveys were pooled, and the fixed-effects method was used. Among the 484 dental students, the pooled carriage rate was 4.1% (95% CI, 2.4%-5.8%).
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