title: Carriage of methicillin-resistant Staphylococci and their SCCmec types in a long-term-care facility.
abstract: Following an outbreak caused by staphylococcal cassette chromosome mec (SCCmec) type V methicillin (meticillin)-resistant Staphylococcus aureus (MRSA), a point-prevalence survey of the nasal carriage of staphylococci was conducted in a long-term-care facility in northern Finland in 2004. The focus was directed at methicillin-resistant coagulase-negative staphylococci (MR-CNS) and their SCCmec elements. A nasal swab was taken from 76 of the 80 residents 6 months after the onset of the outbreak. Staphylococcal isolates were identified by conventional methods and the GenoType Staphylococcus test, and their SCCmec elements were analyzed. Of the 76 individuals, 24 (32%) carried S. aureus and 67 (88%) CNS in their nostrils. Of the CNS carriers, 41 (61%) had at least one mecA-positive MR-CNS, and two individuals (3%) had both MRSA and methicillin-resistant Staphylococcus epidermidis (MRSE). Among the 61 MR-CNS isolates identified, 49 (80%) were MRSE. The distribution of the SCCmec types was diverse: 20 (33%) were of type IV, 11 (18%) of type V, 4 (6%) of type I or IA, 3 (4%) of type II, and 23 (38%) of new types (with six different combinations of ccr and other mec genes or only mecA). Both of the individuals with MRSA and MRSE shared SCCmec type V among their isolates. Nasal MR-CNS carriage was common among the residents of this long-term-care facility. A variety of SCCmec types, including many new types, were identified among the MR-CNS strains. The horizontal transfer of SCCmec elements is speculated based on the sharing of SCCmec type V between MRSA and MRSE.
authors.affiliation: National Public Health Institute, Department of Bacterial and Inflammatory Diseases, Mannerheimintie 166, 00300 Helsinki, Finland. salha.ibrahem@ktl.fi
authors.forename: Salha
authors.initials: S
authors.lastname: Ibrahem
authors.forename: Saara
authors.initials: S
authors.lastname: Salmenlinna
authors.forename: Anni
authors.initials: A
authors.lastname: Virolainen
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Kerttula
authors.forename: Outi
authors.initials: O
authors.lastname: Lyytikäinen
authors.forename: Henrik
authors.initials: H
authors.lastname: Jägerroos
authors.forename: Markku
authors.initials: M
authors.lastname: Broas
authors.forename: Jaana
authors.initials: J
authors.lastname: Vuopio-Varkila
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D005387:Finland / Q000453:epidemiology; D022761:Gene Transfer, Horizontal; D005798:Genes, Bacterial; D006801:Humans; D007297:Inpatients; D008134:Long-Term Care; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D004269:DNA, Bacterial