Staphylococcus aureus colonization during military service: a prospective cohort study

Aamot, Hege Vangstein; Eskonsipo, Petri K J; Jørgensen, Silje Bakken; Blomfeldt, Anita

doi:10.1016/j.cmi.2017.10.012

Cited by 8 publications

(14 citation statements)

References 25 publications

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“…MRSA SSTI continues to be a major source of morbidity in military trainees in the United States [2, 3] and other countries [21, 22]. In this study, we integrated genomics with comprehensive epidemiologic data to investigate MRSA transmission in US Army Infantry trainees at Fort Benning, GA, a group known to be at increased risk for MRSA colonization and infection.…”

Section: Discussionmentioning

confidence: 99%

Genomic Epidemiology of Methicillin-Resistant Staphylococcus aureus in Two Cohorts of High-Risk Military Trainees

Lee

Millar

Callendrello

et al. 2019

Preprint

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Background. MRSA skin and soft tissue infection (SSTI) is a significant cause of morbidity in military trainees. To guide interventions, it is critical we understand the epidemiology of MRSA in this population. Methods. Two cohorts (‘companies’) of US Army Infantry trainees (N=343) at Fort Benning, GA, USA, were followed during their training cycles (Jun.-Dec. 2015). Trainees had nares, oropharynx, perianal and inguinal areas swabbed for MRSA colonization at five ~2-4 week intervals, and monitored for SSTI throughout training. Epidemiological data were collected. Isolates were sequenced using Illumina HiSeq and NovaSeq. Single-nucleotide polymorphisms and clusters were identified. Multi-locus sequence type (MLST) and antimicrobial resistance genes were predicted from de novo assemblies. Results. 87 trainees were positive at least once for MRSA (12 had SSTI, 2 without any colonization). Excluding those positive at baseline, 43.7% were colonized within the first month of training. 244/254 samples were successfully sequenced (including all SSTI). ST8 (n=135, 100% of SSTI), ST5 (n=81) and ST87 (n=21) were the most represented. Three main Clusters were identified, largely corresponding to these STs. Sub-analyses within Clusters showed multiple importations of MRSA, with transmission subsequently predominantly within, rather than between, platoons in each company. Over 50% of trainees were colonized only at other anatomical sites; restricting analyses to nares missed substantial transmission. Conclusions. Serial importations of MRSA into this high-risk setting likely contribute to the ongoing burden of MRSA colonization and infection among military trainees. Sampling multiple anatomical sites is critical for comprehensive characterization of MRSA transmission.

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Section: Discussionmentioning

confidence: 99%

Genomic Epidemiology of Methicillin-Resistant Staphylococcus aureus in Two Cohorts of High-Risk Military Trainees

Lee

Millar

Callendrello

et al. 2019

Preprint

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“…En este estudio se observó una prevalencia de SAMR-AC en soldados de 7,8%, superior a la encontrada en la mayoría de los estudios publicados (13)(14)(15)(16)(17)(18)(19)(20). En un estudio prospectivo observacional donde fueron evaluados 812 soldados durante diez semanas, la colonización inicial de SAMR-AC fue menor a la de SAMS (3% vs. 28%), pero el desarrollo de infecciones fue mayor entre los colonizados con SAMR-AC (38% vs. 3%) ( 22), lo cual demuestra la mayor virulencia de las cepas resistentes de la comunidad anteriormente citada.…”

Section: Discussionunclassified

“…Las condiciones habitacionales de los soldados probablemente aumenten la tasa de colonización e infecciones por SAU, según han demostrado diversos estudios (13)(14)(15)(16)(17)(18)(19)(20). En la Base Naval Puerto Belgrano, donde se realizó este trabajo, anualmente se seleccionan aproximadamente 700 aspirantes para ingresar a la escuela de suboficiales.…”

Section: Introductionunclassified

Colonización por Staphylococcus aureus meticilino resistente de la comunidad y factores predisponentes en soldados ingresantes a una institución militar

Chedrese¹,

Mutti²,

Pelozo³

et al. 2019

ASEI

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Introducción: La colonización por Staphylococcus aureus meticilino resistente adquirido en la comunidad (SAMR-AC) ha ido en aumento desde su aparición. El objetivo de este trabajo fue conocer la prevalencia de colonización por SAMR-AC en soldados, determinar los factores predisponentes y conocer la dinámica de colonización a los seis meses de convivencia. Materiales y métodos: Estudio descriptivo, de corte transversal. Se incluyó una muestra de los soldados ingresantes a un establecimiento militar. Se tomó una muestra de hisopado nasal y, en caso de aislamiento de Staphylococcus aureus, se determinó la frecuencia de la cepa meticilino resistente de la comunidad. Se realizó una encuesta sobre los posibles factores predisponentes para la colonización. Luego de seis meses de convivencia se efectuó un nuevo hisopado y se analizó el cambio en la prevalencia y la dinámica de colonización. Resultados: Se incluyeron 346 soldados provenientes de diferentes provincias de Argentina. La prevalencia inicial de colonización por Staphylococcus aureus meticilino resistente de la comunidad fue 7,8% y, luego de seis meses, 9,5% (aumento del 21,8%). Los factores que mostraron asociación con la colonización por SAMR-AC fueron los antecedentes de un conviviente con forunculosis (p=0,02), forunculosis previa (p=0,04) y forunculosis en familiar de primer grado no conviviente (p=0.03). Se constató persistencia de colonización en el 79% del grupo inicial. Conclusiones: Se observó una prevalencia de colonización por Staphylococcus aureus meticilino resistente de la comunidad del 7,8%, superior a la encontrada en la mayoría de los estudios publicados.

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“…This prospective cohort study was conducted as previously described (6). Briefly, military recruits, stationed at three different garrisons within the same geographical region in Norway and with some degree of interaction during service, were screened for S. aureus colonization at enrolment in January 2013 and discharge in December 2013.…”

Section: Methodsmentioning

confidence: 99%

“…Routine AST was performed by the disc diffusion method using EUCASTs breakpoint tables (version 4.0, 2014) for interpretation of zone diameters (http://www.EUCAST.org) for the following antibiotics: ciprofloxacin, clindamycin, erythromycin, fusidic acid, gentamicin, linezolid, penicillin, tetracycline and trimethoprim/sulfamethoxazole. Methicillin susceptibility was reported previously (6). For AST we selected one isolate per spa type/recruit at enrolment and divergent spa types at discharge assuming that isolates with identical spa types at different sampling times in one individual had identical AST profiles.…”

Section: Methodsmentioning

confidence: 99%

Is increased Staphylococcus aureus colonization during military service caused by specific genotypes? Molecular examination of long‐term carriage in a prospective cohort study

Blomfeldt

Jørgensen

Helmersen

et al. 2021

APMIS

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A 22% increase in Staphylococcus aureus colonization was observed in Norwegian recruits during first year of military service. The aim was to determine whether specific genotypes caused the increase and to examine carriage status based on genotyping. Characterization of S. aureus from nose, throat and perineum sampled at enrolment and discharge included spa typing, MLVA, detection of PVL genes and antimicrobial susceptibility testing. spa typing demonstrated high and stable genetic diversity. The three most frequent spa types were found in 15% of recruits at enrolment and in 29% at discharge. Only t084 increased significantly (p = 0.02). Subtyping revealed that t084, t065 and t002 consisted of 13, 6 and 11 different MLVA types, respectively, at discharge. The military cohort (n = 265) consisted of S. aureus carriers of identical genotype (n = 99, 38%), carriers of non‐identical genotype (n = 52, 20%), intermittent carriers (n = 86, 33%) and non‐carriers (n = 27, 10%). Carrier status was indefinable for one recruit due to unavailable isolates for genotyping. Antibiotic resistance towards erythromycin, fusidic acid and clindamycin increased significantly and above national surveillance levels. The observed increase in S. aureus colonization during military service was caused by many different genotypes implying many transmission routes. Genotype did not correlate with colonization niche or carriage status.

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Staphylococcus aureus colonization during military service: a prospective cohort study

Cited by 8 publications

References 25 publications

Genomic Epidemiology of Methicillin-Resistant Staphylococcus aureus in Two Cohorts of High-Risk Military Trainees

Genomic Epidemiology of Methicillin-Resistant Staphylococcus aureus in Two Cohorts of High-Risk Military Trainees

Colonización por Staphylococcus aureus meticilino resistente de la comunidad y factores predisponentes en soldados ingresantes a una institución militar

Is increased Staphylococcus aureus colonization during military service caused by specific genotypes? Molecular examination of long‐term carriage in a prospective cohort study

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