Nasal carriage of methicillin-resistant Staphylococcus aureus among preclinical medical students: epidemiologic and molecular characteristics of methicillin-resistant S. aureus clones

Diagn Microbiol Infect Dis. 2011 May;70(1):22-30. doi: 10.1016/j.diagmicrobio.2010.12.004.

Abstract

Between May 2008 and October 2009, a total of 2103 interns were randomly tested for nasal colonization of S. aureus and methicillin-resistant Staphylococcus aureus (MRSA). The prevalence of S. aureus among staphylococci specimens was 23.1%, and among the total S. aureus the MRSA prevalence was 9.4%. MRSA isolates were further subtyped using genetic element staphylococcal cassette chromosome mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE) band pattern, and multilocus sequence typing. SCCmec type IVa was the most prevalent strain, at 45.4 %. Eleven PFGE patterns were identified in MRSA strains, with 1 predominant (pulsotype A, 45.5%). Eight strains which belonged to clonal complex 78 carried type IVa SCCmec and produced type 3 coagulase. Panton-Valentine leukocidin (PVL) genes (lukS and F-PV) were identified in 10 (45.4%) MRSA strains; these predominately carried ϕSa2958type and ϕSa108PVL-like type PVL phages. After inducing prophages, 8 strains infected other S. aureus isolates and could generate novel PVL-positive strains of S. aureus. The present study demonstrates that interns can carry certain MRSA strains asymptomatically and contribute to the spread of MRSA between the community and hospital.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacterial Toxins / genetics
  • Bacterial Typing Techniques
  • Carrier State / epidemiology*
  • Carrier State / microbiology
  • Coagulase / genetics
  • Electrophoresis, Gel, Pulsed-Field
  • Exotoxins / genetics
  • Female
  • Genotype
  • Humans
  • Leukocidins / genetics
  • Male
  • Methicillin-Resistant Staphylococcus aureus / classification*
  • Methicillin-Resistant Staphylococcus aureus / genetics
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Molecular Typing
  • Multilocus Sequence Typing
  • Nasal Cavity / microbiology*
  • Prevalence
  • Prophages / isolation & purification
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Students, Medical*
  • Young Adult

Substances

  • Bacterial Toxins
  • Coagulase
  • Exotoxins
  • Leukocidins
  • Panton-Valentine leukocidin