Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus among nasal carriage strains isolated from emergency department patients and healthcare workers in central Taiwan

J Microbiol Immunol Infect. 2019 Apr;52(2):248-254. doi: 10.1016/j.jmii.2018.08.015. Epub 2018 Sep 15.

Abstract

Background and objective: Screening and identification of methicillin-resistant Staphylococcus aureus (MRSA) carriage are helpful for controlling MRSA dissemination in hospitals. The aim of our study was to determine the prevalence of nasal carriages and diversity of MRSA among patients and healthcare workers (HCWs) at two regional hospitals in Taiwan.

Methods: Nasal swabs were obtained prospectively from 204 patients visiting the emergency department (ED) and 326 HCWs in two regional hospitals in Changhua, Taiwan, between February 2015 and June 2015. All the MRSA isolates were further molecularly characterized.

Results: Of the 204 participating patients, the nasal carriage rates of S. aureus and MRSA were 22.1% and 7.8%, respectively. For HCWs, the S. aureus and MRSA carriage rates were 26.1% and 6.1%, respectively. There was no statistically significant difference in MRSA carriage rate between patients and HCWs (P = 0.447). Patients receiving hemodialysis were significantly associated with MRSA colonization (P = 0.012). The leading three sequence types (ST) were ST59 (16, 44.4%), ST45 (11, 30.6%), and ST239 (3, 8.3%) for all 36 MRSA isolates. ST59/SCCmec IV/t437/PVL-negative and ST45/SCCmec V/t1081/PVL-negative were the predominant clones among HCWs (30%) and participating patients (19%), respectively.

Conclusion: Overall, a substantial proportion of patients visiting the ED and HCWs harbored CA-MRSA, mostly ST59 strains, in their nares. It is noteworthy that MRSA ST45 strains supplanted ST239 as the second leading nasal MRSA colonization strain in our study.

Keywords: Methicillin-resistant Staphylococcus aureus (MRSA); Molecular epidemiology; Nasal carriage.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacterial Typing Techniques
  • Carrier State
  • DNA, Bacterial / genetics
  • Emergency Service, Hospital*
  • Female
  • Health Personnel*
  • Hospitals
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus / classification
  • Methicillin-Resistant Staphylococcus aureus / genetics*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Microbial Sensitivity Tests
  • Middle Aged
  • Molecular Epidemiology*
  • Molecular Typing
  • Nasal Cavity / microbiology*
  • Prevalence
  • Renal Dialysis
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / classification
  • Staphylococcus aureus / genetics
  • Staphylococcus aureus / isolation & purification
  • Taiwan / epidemiology
  • Young Adult

Substances

  • DNA, Bacterial