Population Dynamics of Nasal Strains of Methicillin-Resistant Staphylococcus aureus—and Their Relation to Community-Associated Disease Activity

BackgroundNasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) plays a key role in the epidemiology and pathogenesis of disease. The purpose of this study was to determine the characteristics and dynamics of nasal strains of MRSA, as well as their relation to community-associated dis...

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Bibliographic Details
Published in:The Journal of infectious diseases 2005-09, Vol.192 (5), p.811-818
Main Authors: Pan, Erica S., Diep, Binh An, Charlebois, Edwin D., Auerswald, Colette, Carleton, Heather A., Sensabaugh, George F., Perdreau-Remington, Françoise
Format: Article
Language:English
Subjects:
Adolescent
Adult
AIDS
Bacteria
Bacteriology
Biological and medical sciences
Community-Acquired Infections - epidemiology
Community-Acquired Infections - microbiology
Cross-Sectional Studies
DNA, Bacterial - chemistry
DNA, Bacterial - genetics
Electrophoresis, Gel, Pulsed-Field
Epidemiology
Female
Fundamental and applied biological sciences. Psychology
Genotype
Genotypes
Homeless Persons
Humans
Infections
Infectious diseases
Injections
Male
Medical sciences
Methicillin Resistance
Methicillin resistant staphylococcus aureus
Microbial Sensitivity Tests
Microbiology
Miscellaneous
Nasal Mucosa - microbiology
Nose diseases
Population dynamics
Predisposing factors
San Francisco - epidemiology
Sequence Analysis, DNA
Staphylococcal Infections - epidemiology
Staphylococcal Infections - microbiology
Staphylococcus aureus
Staphylococcus aureus - genetics
Staphylococcus aureus - growth & development
Staphylococcus aureus - pathogenicity
Staphylococcus aureus - physiology
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Summary:BackgroundNasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) plays a key role in the epidemiology and pathogenesis of disease. The purpose of this study was to determine the characteristics and dynamics of nasal strains of MRSA, as well as their relation to community-associated disease activity MethodsThis study is a cross-sectional survey and molecular epidemiologic analysis of nasal colonization by S. aureus in homeless and runaway youths, an underserved population at high risk for staphylococcal disease ResultsOf the 308 study participants, 27.6% carried S. aureus and 6.2% carried MRSA. Subgroups of individuals with increased MRSA carriage rates were also at highest risk for community-associated MRSA infection; these subgroups included individuals with either HIV infection or AIDS, injection drug users, patients with abscesses, and those recently hospitalized. Multilocus sequence typing and pulsed-field gel electrophoresis identified 2 genotypes—ST59:P (USA1000) and ST8:S (USA300)—that accounted for 84.2% (16/19) of the MRSA isolates carried. The genotypes were distinct from nosocomial genotypes endemic in the hospital, although they originated from individuals with prior exposure to health care ConclusionsComparison of MRSA strains from asymptomatic carriers versus concurrently collected community-associated clinical strains from patients treated at local health-care facilities allowed for the identification of 3 population dynamics of nasal strains of MRSA: (1) endemic clones—for example, ST8:C and ST59:P—sustained asymptomatic carriage and infection over prolonged periods; (2) an epidemic clone, ST8:S, demonstrated enhanced capacity for rapid transmission and widespread infections; and (3) an outbreak clone, ST30:Z (USA1100), was highly infectious but exhibited poor asymptomatic transmission
ISSN:0022-1899
1537-6613
DOI:10.1086/432072