Mehraj Jaishri, Akmatov Manas K, Strömpl Julia, Gatzemeier Anja, Layer Franziska, Werner Guido, Pieper Dietmar H, Medina Eva, Witte Wolfgang, Pessler Frank, Krause Gérard
Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany; Hanover Medical School, Hannover, Germany.
Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany; TWINCORE Centre for Experimental and Clinical Infection Research, Hannover, Germany.
PLoS One. 2014 Sep 24;9(9):e107937. doi: 10.1371/journal.pone.0107937. eCollection 2014.
The findings from truly randomized community-based studies on Staphylococcus aureus nasal colonization are scarce. Therefore we have examined point prevalence and risk factors of S. aureus nasal carriage in a non-hospitalized population of Braunschweig, northern Germany.
A total of 2026 potential participants were randomly selected through the resident's registration office and invited by mail. They were requested to collect a nasal swab at home and return it by mail. S. aureus was identified by culture and PCR. Logistic regression was used to determine risk factors of S. aureus carriage.
Among the invitees, 405 individuals agreed to participate and 389 provided complete data which was included in the analysis. The median age of the participants was 49 years (IQR: 39-61) and 61% were females. S. aureus was isolated in 85 (21.9%; 95% CI: 18.0-26.2%) of the samples, five of which were MRSA (1.29%; 95% CI: 0.55-2.98%). In multiple logistic regression, male sex (OR = 3.50; 95% CI: 2.01-6.11) and presence of allergies (OR = 2.43; 95% CI: 1.39-4.24) were found to be associated with S. aureus nasal carriage. Fifty five different spa types were found, that clustered into nine distinct groups. MRSA belonged to the hospital-associated spa types t032 and t025 (corresponds to MLST CC 22), whereas MSSA spa types varied and mostly belonged to spa-CC 012 (corresponds to MLST CC 30), and spa-CC 084 (corresponds to MLST CC 15).
This first point prevalence study of S. aureus in a non-hospitalized population of Germany revealed prevalence, consistent with other European countries and supports previous findings on male sex and allergies as risk factors of S. aureus carriage. The detection of hospital-associated MRSA spa types in the community indicates possible spread of these strains from hospitals into the community.
关于金黄色葡萄球菌鼻腔定植的真正基于社区的随机研究结果很少。因此，我们调查了德国北部不伦瑞克非住院人群中金黄色葡萄球菌鼻腔携带的现患率和危险因素。
通过居民登记办公室随机选择了2026名潜在参与者，并通过邮件邀请他们。要求他们在家中采集鼻拭子并通过邮件寄回。通过培养和PCR鉴定金黄色葡萄球菌。采用逻辑回归确定金黄色葡萄球菌携带的危险因素。
在受邀者中，405人同意参与，389人提供了完整数据并纳入分析。参与者的中位年龄为49岁（四分位间距：39 - 61岁），61%为女性。85份样本（21.9%；95%置信区间：18.0 - 26.2%）中分离出金黄色葡萄球菌，其中5份为耐甲氧西林金黄色葡萄球菌（MRSA，1.29%；95%置信区间：0.55 - 2.98%）。在多因素逻辑回归中，发现男性（比值比[OR] = 3.50；95%置信区间：2.01 - 6.11）和存在过敏（OR = 2.43；95%置信区间：1.39 - 4.24）与金黄色葡萄球菌鼻腔携带有关。发现了55种不同的spa型，它们聚为9个不同的组。MRSA属于与医院相关的spa型t032和t025（对应多位点序列分型[MLST]CC22），而甲氧西林敏感金黄色葡萄球菌（MSSA）的spa型各不相同，大多属于spa-CC012（对应MLST CC30）和spa-CC084（对应MLST CC15）。
这项针对德国非住院人群的首次金黄色葡萄球菌现患率研究揭示的现患率与其他欧洲国家一致，并支持了之前关于男性和过敏是金黄色葡萄球菌携带危险因素的研究结果。在社区中检测到与医院相关的MRSA spa型表明这些菌株可能从医院传播到社区。
