Community-acquired methicillin-resistant Staphylococcus aureus can persist in the throat

Int J Med Microbiol. 2018 Jun;308(4):469-475. doi: 10.1016/j.ijmm.2018.04.002. Epub 2018 Apr 12.

Abstract

Colonization by Staphylococcus aureus is an important factor in infections caused by this microorganism. Among the colonization niches of staphylococci are the nose, skin, intestinal tract, and, recently, the throat has been given relevance. Infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) can be fatal. Persistence of S. aureus is an important process in the pathogenesis of this microorganism and must be studied. The aim of this study was to determine the persistence of S. aureus in the throat, and characterized the strains. We studied the persistence of S. aureus for 6 years in the throat of apparently healthy people. The isolated strains from the persistent carriers were characterized through PFGE, spa-typing, SCCmec typing, resistance to methicillin, presence of virulence genes (adhesins and toxins), and the formation of biofilm. We found persistent and intermittent carriers of S. aureus in the throat, with methicillin-sensitive (MSSA), methicillin-resistant (MRSA) strains, and confirmed for the first time that CA-MRSA colonizes this niche. These strains can colonize persistently the throat for four years or more. Typification of strains through PFGE and spa-typing revealed that some carriers present the same strain, whereas others present different strains along the period of persistence. Almost all strains induced a strong biofilm formation. All strains presented adhesin and toxin genes, but no shared genotype was found. We conclude that S. aureus, including CA-MRSA strains, can remain persistently in the throat, finding a wide variability among the persistent strains.

Keywords: CA-MRSA; Persistence; Staphylococcus aureus; Throat; Virulence genes.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacterial Typing Techniques
  • Biofilms / growth & development
  • Carrier State / microbiology*
  • Community-Acquired Infections / microbiology
  • DNA, Bacterial / genetics*
  • Female
  • Genes, Bacterial / genetics
  • Humans
  • Longitudinal Studies
  • Male
  • Methicillin-Resistant Staphylococcus aureus / genetics
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Middle Aged
  • Pharynx / microbiology*
  • Staphylococcal Infections / microbiology*

Substances

  • DNA, Bacterial