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      Molecular Diversity of Staphylococcus aureus Colonizing the Upper Respiratory Tract of Residents and Staff in A Nursing Home

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          Abstract

          Elderly people living in nursing homes are a high-risk population for Staphylococcus aureus infection. Multiple comorbidities, a weakened immune system, inadequate hygienic conditions, and crowding might increase the prevalence rates of this opportunistic pathogen. However, the epidemiological aspects, genetic diversity, and transmission of S. aureus in nursing homes are still poorly understood, especially in Poland. This study aimed to determine the genetic relatedness and prevalence of colonization of S. aureus isolated from the anterior nares and the throat of residents and staff in a nursing home located in Lublin, Poland. The study showed a high S. aureus prevalence rate among participants (46.1%), yet there was a low frequency of MRSA strains among residents (1.7%) and staff (0%). The multiple-locus variable-number tandem-repeat fingerprinting (MLVF) analysis demonstrated a high degree of genetic diversity of S. aureus strains colonizing the anterior nares and the throat of the participants. The occurrence of simultaneous colonization with more than one unique S. aureus strain in any one individual as well as the incidence of colonization with the same genetic variant of S. aureus in different individuals was observed. These findings suggest that inter-participant S. aureus transmission might contribute to the development of cross-infections.

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          Staphylococcus aureus infection dynamics

          Eric Pollitt, Piotr T. Szkuta, Nicola Burns … (2018)
          Staphylococcus aureus is a human commensal that can also cause systemic infections. This transition requires evasion of the immune response and the ability to exploit different niches within the host. However, the disease mechanisms and the dominant immune mediators against infection are poorly understood. Previously it has been shown that the infecting S. aureus population goes through a population bottleneck, from which very few bacteria escape to establish the abscesses that are characteristic of many infections. Here we examine the host factors underlying the population bottleneck and subsequent clonal expansion in S. aureus infection models, to identify underpinning principles of infection. The bottleneck is a common feature between models and is independent of S. aureus strain. Interestingly, the high doses of S. aureus required for the widely used “survival” model results in a reduced population bottleneck, suggesting that host defences have been simply overloaded. This brings into question the applicability of the survival model. Depletion of immune mediators revealed key breakpoints and the dynamics of systemic infection. Loss of macrophages, including the liver Kupffer cells, led to increased sensitivity to infection as expected but also loss of the population bottleneck and the spread to other organs still occurred. Conversely, neutrophil depletion led to greater susceptibility to disease but with a concomitant maintenance of the bottleneck and lack of systemic spread. We also used a novel microscopy approach to examine abscess architecture and distribution within organs. From these observations we developed a conceptual model for S. aureus disease from initial infection to mature abscess. This work highlights the need to understand the complexities of the infectious process to be able to assign functions for host and bacterial components, and why S. aureus disease requires a seemingly high infectious dose and how interventions such as a vaccine may be more rationally developed.
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            New method for typing Staphylococcus aureus strains: multiple-locus variable-number tandem repeat analysis of polymorphism and genetic relationships of clinical isolates.

            A Sabat, J Krzysztoń-Russjan, W. Strzalka … (2003)
            The PCR-based methodology applied to multiple-locus variable numbers of tandem repeat (VNTR) analysis was recently shown to be a useful technique for the molecular typing of clinical isolates of several bacterial species. We have adopted this method for the molecular typing of methicillin-resistant Staphylococcus aureus. Five staphylococcal VNTR loci (sdr, clfA, clfB, ssp, and spa) were subjected to analysis, and it was shown that the method allows typing of S. aureus strains with the discriminatory power and reproducibility of pulsed-field gel electrophoresis while at the same time being rapid and applicable to analysis of large numbers of isolates.
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              Staphylococcus aureus throat colonization is more frequent than colonization in the anterior nares.

              Peter Nilsson, Torvald Ripa (2006)
              The aim of this study was to determine the frequency and persistence of Staphylococcus aureus carriage in the throat in relation to anterior naris carriage. By use of a sensitive enrichment broth, S. aureus was cultured from the two sites from 259 patients upon admission to an orthopedic ward and from 87 staff members of the same ward. The throat was the most common carriage site in both groups. Forty percent of the patients and 54% of the staff were positive for S. aureus in the throat, compared to 31% and 36%, respectively, in the anterior nares. To determine the persistence of carriage, 67 individuals were repeatedly sampled from the anterior nares and the throat over 2 years (5 to 10 sampling occasions; mean, 7.8). The majority, 58% (39/67), were defined as persistent carriers of S. aureus, considering culture results from both sites. Of the 39 persistent carriers, 15 individuals were culture positive from only the throat on more than half of the sampling occasions (these are called preferential throat carriers) while only 5% (two individuals) were preferential anterior naris carriers by use of the same definition. Typing of the collected S. aureus isolates by pulsed-field gel electrophoresis revealed that the same strain of S. aureus was present, over time, in the throat of an individual at least to the same extent as in the anterior nares. Throat carriage was at least as persistent as carriage in the anterior nares.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Pol J Microbiol
                Journal ID (iso-abbrev): Pol. J. Microbiol
                Journal ID (publisher-id): PJM
                Title: Polish Journal of Microbiology
                Publisher: Exeley Inc.
                ISSN (Print): 1733-1331
                ISSN (Electronic): 2544-4646
                Publication date (Print): September 2019
                Publication date (Electronic): 03 September 2019
                Volume: 68
                Issue: 3
                Pages: 371-376
                Affiliations
                Chair and Department of Pharmaceutical Microbiology with Laboratory for Microbiological Diagnostics , Medical University of Lublin , Lublin, Poland
                Author notes
                * Corresponding author: M. Kasela, Chair and Department of Pharmaceutical Microbiology with Laboratory for Microbiological Diagnostics, Medical University of Lublin, Lublin, Poland; e-mail: kasela.martyna@ 123456gmail.com
                Article
                Publisher ID: exeley
                DOI: 10.33073/pjm-2019-039
                PMC ID: 7256757
                PubMed ID: 31880882
                SO-VID: 8a5758ae-9f63-409c-93e7-5f0e761d5dc2
                Copyright © © 2019 Martyna Kasela et al.
                License:

                This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License ( https://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 06 May 2019
                Date revision received : 24 July 2019
                Date accepted : 25 July 2019
                Categories
                Subject: Microbiology

                Keywords: staphylococcus aureus,colonization,elderly,genotyping,nursing home
                Data availability:
                Keywords: staphylococcus aureus, colonization, elderly, genotyping, nursing home

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