Challenges in Estimating Characteristics of Staphylococcus aureus Nasal Carriage Among Humans Enrolled in Surveillance Studies

Bibliographic Details
Title: Challenges in Estimating Characteristics of Staphylococcus aureus Nasal Carriage Among Humans Enrolled in Surveillance Studies
Authors: Thanh-Thao Le, Maya Nadimpalli, Jianyong Wu, Christopher D. Heaney, Jill R. Stewart
Source: Frontiers in Public Health, Vol 6 (2018)
Publisher Information: Frontiers Media S.A., 2018.
Publication Year: 2018
Collection: LCC:Public aspects of medicine
Subject Terms: Staphylococcus, MRSA, antibiotic resistance, opportunistic pathogen, nasal carriage, surveillance, Public aspects of medicine, RA1-1270
More Details: Evaluating carriage of Staphylococcus aureus, an opportunistic pathogen of humans and animals capable of causing antibiotic-resistant infections, is epidemiologically important. However, clinical and epidemiological surveillance studies of S. aureus typically rely on characterizing one isolate per individual, which may not represent the actual population diversity in a carrier. The objective of this study was to determine if one isolate is sufficient for determining carrier status of particular strains or characteristics of S. aureus in a healthy (non-hospitalized) human population. We compared spa types, genetic markers (mecA, scn), and antibiotic resistance profiles of 10 S. aureus isolates recovered from a single nasal swab for each of 19 participants (190 isolates total) selected from a cohort of industrial hog operation workers and their household members. Participants included both persistent (n = 10) and intermediate (n = 9) carriers of S. aureus. Among the participants, 17 (89%) carried a single S. aureus spa type intranasally and the other two carried dominant spa types. Less similarity was observed for genes encoded on mobile genetic elements (mecA, scn) and antibiotic resistance profiles. Statistical modeling, based on receiving operating characteristic curves, suggests that three to five isolates may be necessary to accurately assign nasal carriage status for these more variable characteristics. Variability was observed for both persistent and intermediate carriers of S. aureus. These results suggest that surveillance studies that rely on testing one S. aureus isolate are likely to identify predominant spa types but may not fully capture more variable characteristics of S. aureus, including antibiotic resistance. Surveillance studies that rely on testing one isolate may underestimate prevalence of nasal carriage of S. aureus with these more variable characteristics.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2296-2565
Relation: https://www.frontiersin.org/article/10.3389/fpubh.2018.00163/full; https://doaj.org/toc/2296-2565
DOI: 10.3389/fpubh.2018.00163
Access URL: https://doaj.org/article/44edb0db4abb4abf9b59c4e74f9ad534
Accession Number: edsdoj.44edb0db4abb4abf9b59c4e74f9ad534
Database: Directory of Open Access Journals
More Details
ISSN:22962565
DOI:10.3389/fpubh.2018.00163
Published in:Frontiers in Public Health
Language:English