Molecular Epidemiology of Staphylococcus aureus in the General Population in Northeast Germany: Results of the Study of Health in Pomerania (SHIP-TREND-0)

Abstract

h Population-based studies on Staphylococcus aureus nasal colonization are scarce. We examined the prevalence, resistance, and molecular diversity of S. aureus in the general population in Northeast Germany. Nasal swabs were obtained from 3,891 adults in the large-scale population-based Study of Health in Pomerania (SHIP-TREND). Isolates were characterized using spa genotyping, as well as antibiotic resistance and virulence gene profiling. We observed an S. aureus prevalence of 27.2%. Nasal S. aureus carriage was associated with male sex and inversely correlated with age. Methicillin-resistant S. aureus (MRSA) accounted for 0.95% of the colonizing S. aureus strains. MRSA carriage was associated with frequent visits to hospitals, nursing homes, or retirement homes within the previous 24 months. All MRSA strains were resistant to multiple antibiotics. Most MRSA isolates belonged to the pandemic European hospital-acquired MRSA sequence type 22 (HA-MRSA-ST22) lineage. We also detected one livestock-associated MRSA ST398 (LA-MRSA-ST398) isolate, as well as six livestock-associated methicillin-susceptible S. aureus (LA-MSSA) isolates (clonal complex 1 [CC1], CC97, and CC398). spa typing revealed a diverse but also highly clonal S. aureus population structure. We identified a total of 357 spa types, which were grouped into 30 CCs or sequence types. The major seven CCs (CC30, CC45, CC15, CC8, CC7, CC22, and CC25) included 75% of all isolates. Virulence gene patterns were strongly linked to the clonal background. In conclusion, MSSA and MRSA prevalences and the molecular diversity of S. aureus in Northeast Germany are consistent with those of other European countries. The detection of HA-MRSA and LA-MRSA within the general population indicates possible transmission from hospitals and livestock, respectively, and should be closely monitored.

Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus in Workers in the Food Industry

“…For nine countries in Central Europe den Heijer et al (2013) reported low MRSA prevalence in the healthy community from 0.0% (Sweden) to 2.1% (Belgium). Other studies from Europe showed similar colonization rates (Sakwinska et al, 2009;Lozano et al, 2011;Mehraj et al, 2014;Holtfreter et al, 2016). Similar or slightly elevated carriage rates were also reported in studies from Australia and several Asian countries (Munckhof et al, 2008;Chatterjee et al, 2009;Ma et al, 2011;Chen et al, 2013).…”

“…For Central Europe carriage rates reported from the general population were in the range of 20%-35% Sakwinska et al, 2009;Sangvik et al, 2011;den Heijer et al, 2013;Holtfreter et al, 2016). In the US prevalences around 30% were documented (Kuehnert 2.…”

“…In South America rather high carriage rates between 30% and 60% were reported (Hamdan-Partida et al, 2010;Ruimy et al, 2010). In several studies nasal carriage was associated with male sex and younger age (Skramm et al, 2011;Gorwitz et al, 2008;Holtfreter et al, 2016); however, in general, several different factors contribute to S. aureus carriage including those associated with the host, the pathogen itself, and the environment (Mulcahy and McLoughlin, 2016;Kluytmans et al, 1997).…”

Characterization of Methicillin-Resistant Staphylococcus aureus Isolated from Healthy Turkeys and Broilers Using DNA Microarrays

“…The spa typing was performed according to previously published protocols using primers spa-1113f and spa-1514r (Hasman et al, 2010) and alternative primers spa-1095f and spa-1517r (Votintseva et al, 2014; Holtfreter et al, 2016). Chromatograms were analyzed using Ridom StaphType v2.0.3 software (Ridom GmbH).…”

Clonal and drug resistance dynamics of methicillin‐resistant Staphylococcus aureus in pediatric populations in China

“…For example, ST239‐IIIA‐t037, the most common in Portugal in the late 1990s has been progressively replaced by ST22‐IV‐t022 and ST5‐II‐t067 clones . A Germany study covering 2000‐2010 illustrated that CC5/ST228‐MRSA‐I and CC45‐MRSA‐IV were replaced by CC5‐MRSA‐II and CC22‐MRSA‐IV, and CC22‐MRSA‐IV is currently the major clone …”