Molecular Epidemiology of Staphylococcus aureus in the General Population in Northeast Germany: Results of the Study of Health in Pomerania (SHIP-TREND-0)
Journal of Clinical Microbiology November 2016 V.54 N.11 P.2774-2785
Silva Holtfreter, Dorothee Grumann, Veronika Balau, Annette Barwich, Julia Kolata, André Goehler, Stefan Weiss, Birte Holtfreter, Stephanie S. Bauerfeind, Paula Döring, Erika Friebe, Nicole Haasler, Kristin Henselin, Katrin Kühn, Sophie Nowotny, Dörte Radke, Katrin Schulz, Sebastian R. Schulz, Patricia Trübe, Chi Hai Vu, Birgit Walther, Susanne Westphal, Christiane Cuny, Wolfgang Witte, Henry Völzke, Hans Jörgen Grabe, Thomas Kocher, Ivo Steinmetz, and Barbara M. Bröker
aDepartment of Immunology, University Medicine Greifswald, Greifswald, Germany
bFriedrich-Loeffler Institute for Medical Microbiology, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany
cDepartment of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany
dDepartment of Restorative Dentistry, Periodontology, Endodontology and Pedodontics, University Medicine Greifswald, Greifswald, Germany
eInstitute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
fCentre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
gRobert Koch Institute, Wernigerode Branch, National Reference Center for Staphylococci, Wernigerode, Germany
hDepartment of Psychiatry und Psychotherapy, University Medicine Greifswald, Greifswald, Germany
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.