Dynamics of acquisition and loss of carriage of Staphylococcus aureus strains in the community: The effect of clonal complex - 06/04/14
, A. Sarah Walker a, c, h, Heather Godwin c, d, Rowena Fung a, c, Antonina Votintseva a, Rory Bowden c, e, f, David Mant g, Timothy E.A. Peto a, c, Derrick W. Crook a, c, i, Kyle Knox c, g, iSummary |
Background |
Staphylococcus aureus nasal carriage increases infection risk. However, few studies have investigated S. aureus acquisition/loss over >1 year, and fewer still used molecular typing.
Methods |
1123 adults attending five Oxfordshire general practices had nasal swabs taken. 571 were re-swabbed after one month then every two months for median two years. All S. aureus isolates were spa-typed. Risk factors were collected from interviews and medical records.
Results |
32% carried S. aureus at recruitment (<1% MRSA). Rates of spa-type acquisition were similar in participants S. aureus positive (1.4%/month) and negative (1.8%/month, P = 0.13) at recruitment. Rates were faster in those carrying clonal complex (CC)15 (adjusted (a)P = 0.03) or CC8 (including USA300) (aP = 0.001) at recruitment versus other CCs. 157/274 (57%) participants S. aureus positive at recruitment returning ≥12 swabs carried S. aureus consistently, of whom 135 carried the same spa-type. CC22 (including EMRSA-15) was more prevalent in long-term than intermittent spa-type carriers (aP = 0.03). Antibiotics transiently reduced carriage, but no other modifiable risk factors were found.
Conclusions |
Both transient and longer-term carriage exist; however, the approximately constant rates of S. aureus gain and loss suggest that ‘never’ or truly ‘persistent’ carriage are rare. Long-term carriage varies by strain, offering new explanations for the success of certain S. aureus clones.
Le texte complet de cet article est disponible en PDF.Keywords : Staphylococcus aureus, Molecular epidemiology, Colonisation, spa-typing, Carriage duration
Plan
| ☆ | Presentation at previous meetings – Presented as poster at: (1) ICAAC, Boston, 2010. (2) IDweek, San Diego, 2012. |
| ☆☆ | This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
Vol 68 - N° 5
P. 426-439 - mai 2014 Retour au numéro
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