Prevalence, antimicrobial resistance, and genetic lineages of nasal Staphylococcus aureus among medical students at a Spanish University: detection of the MSSA-CC398-IEC-type-C subclade

Res Microbiol. 2024 May-Jun;175(4):104176. doi: 10.1016/j.resmic.2023.104176. Epub 2023 Dec 21.

Abstract

Medical students could be a potential source of Staphylococcus aureus transmission to patients. This cross-sectional study involved samples collected from both nasal nostrils. Samples were processed for S. aureus recovery; the antimicrobial resistance (AMR) phenotype was determined by disc diffusion assays and the spa types and AMR genotypes by PCR/sequencing. A structured questionnaire was administered to students to collate data related to potential risk factors of nasal colonization. Ninety-eight students were included, 50 % were colonized by S. aureus and 12.2 % by MRSA. The mecA gene was detected in all MRSA isolates. The MSSA-CC398-IEC-type C lineage was found among 16.3 % of nasal carriers, of which t571 was the predominant spa-type. MRSA isolates were ascribed to spa types t2226 (CC5, 12 isolates) and t3444 (new spa type, 1 isolate). All MRSA were multi-drug resistant and MSSA were predominantly resistant to erythromycin-clindamycin (inducible-type, mediated by ermT gene). High rates of S. aureus and MRSA nasal carriages were observed in this study. The predominance of the CC398 lineage among MSSA (emergent invasive lineage) represent a relevant finding of public health concern. The role of medical students as potential source of MRSA and MSSA-CC398 transmissions in hospital and community needs to be elucidated in detail.

Keywords: Antimicrobial resistance; MSSA-CC398; Medical students; Nasal carriage; Nosocomial MRSA.

MeSH terms

  • Adult
  • Anti-Bacterial Agents* / pharmacology
  • Bacterial Proteins / genetics
  • Carrier State* / epidemiology
  • Carrier State* / microbiology
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial / genetics
  • Drug Resistance, Multiple, Bacterial / genetics
  • Female
  • Genotype
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus* / classification
  • Methicillin-Resistant Staphylococcus aureus* / drug effects
  • Methicillin-Resistant Staphylococcus aureus* / genetics
  • Methicillin-Resistant Staphylococcus aureus* / isolation & purification
  • Microbial Sensitivity Tests
  • Penicillin-Binding Proteins / genetics
  • Prevalence
  • Spain / epidemiology
  • Staphylococcal Infections* / epidemiology
  • Staphylococcal Infections* / microbiology
  • Staphylococcus aureus* / classification
  • Staphylococcus aureus* / drug effects
  • Staphylococcus aureus* / genetics
  • Staphylococcus aureus* / isolation & purification
  • Students, Medical*
  • Universities
  • Young Adult

Substances

  • mecA protein, Staphylococcus aureus