Molecular characteristics and risk factor analysis of Staphylococcus aureus colonization put insight into CC1 colonization in three nursing homes in Shanghai

• Published in: PloS one Vol. 16; no. 10; p. e0253858
• Main Authors: He, Wei-Ping, Gu, Fei-Fei, Zhang, Ji, Li, Xin-Xin, Xiao, Shu-Zhen, Zeng, Qian, Ni, Yu-Xing, Han, Li-Zhong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07.10.2021; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Aged, 80 and over; Amino acid sequence; Analysis; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antimicrobial agents; Antimicrobial resistance; Atomic properties; Biology and Life Sciences; China; Chromosomes; Cloning; Colonization; Community; Diabetes; Disease control; Drug resistance; Epidemiology; Factor analysis; Factor Analysis, Statistical; Female; Genotype; Health risks; Hospitals; Humans; Laboratories; Linezolid; Male; Medicine; Medicine and Health Sciences; Methicillin; Methicillin-Resistant Staphylococcus aureus - drug effects; Methicillin-Resistant Staphylococcus aureus - genetics; Microbial Sensitivity Tests - methods; Microbiology; Middle Aged; Minocycline; Molecular Epidemiology - methods; Multilocus Sequence Typing; Nursing Homes; Pathogens; Patient admissions; Protein A; Public health; Research and Analysis Methods; Rifampin; Risk analysis; Risk Factors; Safety and security measures; Skin; Spas; Staphylococcal infections; Staphylococcal Infections - drug therapy; Staphylococcal Infections - microbiology; Staphylococcus aureus; Staphylococcus infections; Teicoplanin; Vancomycin; Virulence; Virulence (Microbiology); Virulence Factors - genetics; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0253858

Research indicates that Staphylococcus aureus colonization in the elderly with predisposing risks is associated with subsequent infection. However, the molecular epidemiology and risk factors for S . aureus colonization among residents and staff in nursing homes (NHs) in China remain unclear. A multicenter study was conducted in three NHs in Shanghai between September 2019 and October 2019. We explored the prevalence, molecular epidemiology, and risk factors for S . aureus colonization. All S . aureus isolates were characterized based on antimicrobial resistance, virulence genes, multilocus sequence typing (MLST), staphylococcus protein A ( spa ) typing, and staphylococcal cassette chromosome mec (SCC mec ) typing. NH records were examined for potential risk factors for S . aureus colonization. S . aureus and methicillin-resistant S . aureus (MRSA) isolates were detected in 109 (100 residents and 9 staff, 19.8%, 109/551) and 28 (24 residents and 4 staff, 5.1%, 28/551) subjects among 496 residents and 55 staff screened, respectively. Compared to methicillin-susceptible S . aureus isolates, all 30 MRSA isolates had higher resistance rates to most antibiotics except minocycline, rifampicin, linezolid, vancomycin, and teicoplanin. Sequence type (ST) 1 (21.3%) was the most common sequence type, and t127 (20.5%) was the most common spa type among 122 S . aureus isolates. SCC mec type I (70%) was the dominant clone among all MRSA isolates. CC1 (26/122, 21.3%) was the predominant complex clone (CC), followed by CC398 (25/122, 20.5%), CC5 (20/122, 16.4%) and CC188 (18/122, 14.8%). Female sex (OR, 1.70; 95% CI, 1.04–2.79; P = 0.036) and invasive devices (OR, 2.19; 95% CI, 1.26–3.81; P = 0.006) were independently associated with S . aureus colonization.