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Molecular Epidemiology of Staphylococcus aureus and MRSA in Bedridden Patients and Residents of Long-Term Care Facilities. Antibiotics (Basel) 2022; 11:antibiotics11111526. [PMID: 36358181 PMCID: PMC9686811 DOI: 10.3390/antibiotics11111526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
At present, multidrug-resistant microorganisms are already responsible for community-acquired infections. Methicillin-resistant Staphylococcus aureus (MRSA) poses a serious public health risk worldwide because of the rapid spread and diversification of pandemic clones that are characterized by increasing virulence and antimicrobial resistance. The aim of this study was to identify the prevalence and factors associated with nasal, oral and rectal carriage of S. aureus and MRSA in bedridden patients and residents of long-term care facilities for the elderly (LTCFs) in Botucatu, SP, Brazil. Nasal, oral and rectal swab isolates obtained from 226 LTCF residents or home-bedridden patients between 2017 and 2018 were submitted to susceptibility testing, detection of the mecA gene, SCCmec characterization, and molecular typing by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Logistic regression analysis was used to identify risk factors associated with the presence of S. aureus and MRSA. The prevalence of S. aureus and MRSA was 33.6% (n = 76) and 8% (n = 18), respectively. At the nine LTCFs studied, the prevalence of S. aureus ranged from 16.6% to 85.7% and that of MRSA from 13.3% to 25%. Living in an LTCF, male gender, a history of surgeries, and a high Charlson Comorbidity Index score were risk factors associated with S. aureus carriage, while MRSA carriage was positively associated with male gender. This study showed a high prevalence of S. aureus among elderly residents of small (<15 residents) and medium-sized (15−49 residents) LTCFs and a higher prevalence of MRSA in the oropharynx.
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Stensen DB, Småbrekke L, Olsen K, Grimnes G, Nielsen CS, Sollid JUE, Simonsen GS, Almås B, Furberg AS. Circulating sex-steroids and Staphylococcus aureus nasal carriage in a general female population. Eur J Endocrinol 2021; 184:337-346. [PMID: 33428587 PMCID: PMC7849480 DOI: 10.1530/eje-20-0877] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/16/2020] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Staphylococcus aureus is a major human pathogen, and nasal carriers have an increased risk for infection and disease. The exploration of host determinants for nasal carriage is relevant to decrease infection burden. Former studies demonstrate lower carriage prevalence in women and among users of progestin-only contraceptives. The aim of this study was to investigate the possible associations between circulating sex-steroid hormones and nasal carriage of Staphylococcus aureus in a general population. METHODS In the population-based sixth Tromsø study (2007-2008) nurses collected nasal swab samples from 724 women aged 30-87 not using any exogenous hormones, and 700 of the women had a repeated nasal swab taken (median interval 28 days). We analysed a panel of serum sex-steroids by liquid chromatography tandem mass spectrometry, and collected information about lifestyle, health and anthropometric measures. Multivariable logistic regression was used to study the association between circulating sex-steroids and Staphylococcus aureus carriage (one swab) and persistent carriage (two swabs), while adjusting for potential confounding factors. Women in luteal phase were excluded in the analysis of androgens. RESULTS Staphylococcus aureus persistent nasal carriage prevalence was 22%. One standard deviation increase in testosterone and bioavailable testosterone was associated with lower odds of persistent nasal carriage, (OR = 0.57; 95% CI = 0.35-0.92 and OR = 0.52, 95% CI = 0.30-0.92) respectively. Analysis stratified by menopause gave similar findings. Persistent carriers had lower average levels of androstenedione and DHEA, however, not statistically significant. CONCLUSION This large population-based study supports that women with lower levels of circulating testosterone may have increased probability of Staphylococcus aureus persistent carriage.
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Affiliation(s)
- Dina B Stensen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Correspondence should be addressed to D B Stensen;
| | - Lars Småbrekke
- Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Karina Olsen
- Division of Internal Medicine, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
| | - Guri Grimnes
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Endocrinology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Christopher Sivert Nielsen
- Division of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Johanna U E Sollid
- Research Group for Host-Microbe Interaction, Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Gunnar Skov Simonsen
- Division of Internal Medicine, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
- Research Group for Host-Microbe Interaction, Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørg Almås
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Anne-Sofie Furberg
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway
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Żelaźniewicz A, Nowak-Kornicka J, Figura R, Groyecka-Bernard A, Sorokowski P, Pawłowski B. Pharyngeal Detection of Staphylococcus aureus as a Possible Factor Related to Disgust Sensitivity in Humans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218286. [PMID: 33182475 PMCID: PMC7665136 DOI: 10.3390/ijerph17218286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/26/2022]
Abstract
Disgust triggers behavioral avoidance of pathogen-carrying and fitness-reducing agents. However, because of the cost involved, disgust sensitivity should be flexible, varying as a function of an individual’s immunity. Asymptomatic colonization with Staphylococcus aureus often results from weakened immunity and is a potential source of subsequent infections. In this study, we tested if pharyngeal colonization with S. aureus, evaluated based on a single swab collection, is related to an individual’s disgust sensitivity, measured with the Three Domain Disgust Scale. Levels of immunomodulating hormones (cortisol and testosterone), general health, and body adiposity were controlled. Women (N = 95), compared to men (N = 137), displayed higher sexual disgust sensitivity, but the difference between individuals with S. aureus and without S. aureus was significant only in men, providing support for prophylactic hypothesis, explaining inter-individual differences in disgust sensitivity. Men (but not women) burdened with asymptomatic S. aureus presence in pharynx exhibit higher pathogen disgust (p = 0.04) compared to individuals in which S. aureus was not detected. The positive relationship between the presence of the pathogen and sexual disgust was close to the statistical significance level (p = 0.06), and S. aureus colonization was not related with moral disgust domain.
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Affiliation(s)
- Agnieszka Żelaźniewicz
- Department of Human Biology, University of Wroclaw, 50-138 Wroclaw, Poland; (J.N.-K.); (R.F.); (B.P.)
- Correspondence:
| | - Judyta Nowak-Kornicka
- Department of Human Biology, University of Wroclaw, 50-138 Wroclaw, Poland; (J.N.-K.); (R.F.); (B.P.)
| | - Renata Figura
- Department of Human Biology, University of Wroclaw, 50-138 Wroclaw, Poland; (J.N.-K.); (R.F.); (B.P.)
| | - Agata Groyecka-Bernard
- Institute of Psychology, University of Wroclaw, 50-529 Wroclaw, Poland; (A.G.-B.); (P.S.)
| | - Piotr Sorokowski
- Institute of Psychology, University of Wroclaw, 50-529 Wroclaw, Poland; (A.G.-B.); (P.S.)
| | - Bogusław Pawłowski
- Department of Human Biology, University of Wroclaw, 50-138 Wroclaw, Poland; (J.N.-K.); (R.F.); (B.P.)
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Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves. Infect Control Hosp Epidemiol 2020; 41:1396-1401. [PMID: 32762778 DOI: 10.1017/ice.2020.336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate the effect of the burden of Staphylococcus aureus colonization of nursing home residents on the risk of S. aureus transmission to healthcare worker (HCW) gowns and gloves. DESIGN Multicenter prospective cohort study. SETTING AND PARTICIPANTS Residents and HCWs from 13 community-based nursing homes in Maryland and Michigan. METHODS Residents were cultured for S. aureus at the anterior nares and perianal skin. The S. aureus burden was estimated by quantitative polymerase chain reaction detecting the nuc gene. HCWs wore gowns and gloves during usual care activities; gowns and gloves were swabbed and then cultured for the presence of S. aureus. RESULTS In total, 403 residents were enrolled; 169 were colonized with methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA) and comprised the study population; 232 were not colonized and thus were excluded from this analysis; and 2 were withdrawn prior to being swabbed. After multivariable analysis, perianal colonization with S. aureus conferred the greatest odds for transmission to HCW gowns and gloves, and the odds increased with increasing burden of colonization: adjusted odds ratio (aOR), 2.1 (95% CI, 1.3-3.5) for low-level colonization and aOR 5.2 (95% CI, 3.1-8.7) for high level colonization. CONCLUSIONS Among nursing home patients colonized with S. aureus, the risk of transmission to HCW gowns and gloves was greater from those colonized with greater quantities of S. aureus on the perianal skin. Our findings inform future infection control practices for both MRSA and MSSA in nursing homes.
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School environmental contamination of methicillin-sensitive Staphylococcus aureus as an independent risk factor for nasal colonization in schoolchildren: An observational, cross-sectional study. PLoS One 2018; 13:e0208183. [PMID: 30500843 PMCID: PMC6269093 DOI: 10.1371/journal.pone.0208183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 11/13/2018] [Indexed: 11/19/2022] Open
Abstract
Objective We aim to assess the similarities of proportional, phenotypic, and molecular characteristics between the school environment and schoolchildren on methicillin-sensitive S. aureus (MSSA) isolates. Methods A cross-sectional study was conducted between March 2016 and August 2016 in eight elementary schools in Guangzhou, China. Nasal swabs from students and environmental swabs from school environments were collected. Univariate and multivariate logistic regression analyses under a multistage stratified cluster cross-sectional survey design were performed to access the prevalence relationship and influencing factors, respectively. Phenotypic and molecular characterizations of MSSA isolates were conducted using the Kirby-Bauer disk diffusion method and polymerase chain reaction assays, respectively. Results In total, 1705 schoolchildren and 1240 environmental samples from 40 classes in eight elementary schools obtained between March and August 2016 were include in this study. The rates of MSSA prevalence among schoolchildren and the environment were 11.44% (195/1705) and 4.60% (57/1240), respectively. The odds ratios and 95% confidence intervals (CIs) on the prevalence of MSSA isolates were 1.11 (95% CI, 1.05–1.29; P = 0.010) and 1.04 (95% CI, 1.01–1.07; P = 0.003) for the school or class environment and students, respectively. Similar phenotypic and molecular characteristics were identified between schoolchildren and the environment. A cause and effect relationship could not be established because the study design was cross-sectional. Conclusions Because of the cross-sectional design, we can reveal the association between school environment and schoolchildren on MSSA, but it is not a cause and effect relationship.
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