title: Staphylococcus aureus nasal carriage among patients and health care workers in São Tomé and Príncipe.
abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is a major human pathogen worldwide. However, data on MRSA prevalence in the African continent are scarce and nonexistent for São Tomé and Príncipe. In November 2010 and April 2012, a total of 332 individuals (258 patients and 74 health care workers [HCW]) from Hospital Dr. Ayres Menezes in São Tomé and Príncipe, were screened for S. aureus and MRSA carriage. Fifty-two persons (15.7%) were S. aureus nasal carriers out of which 14 (26.9%) were colonized with MRSA. MRSA isolates belonged to three clonal complexes: CC8 (PFGE type B-ST8-t064/t451-IVg/V), CC88 (PFGE E-ST88-t186/t786-IVa), and CC5 (PFGE K-ST5-t105-IVa/PFGE K-ST105-t002-II). A higher genetic diversity was found among methicillin-susceptible S. aureus (MSSA) isolates where 58.5% (n=24) belonged to four major lineages: PFGE type A-ST15-t084; PFGE C-ST508-t861 or related; PFGE D-ST152-t355 or related; and PFGE G-ST121-t159/t2304. Despite the common nonmultiresistant profile, 98% of the isolates harbored two or more virulence factors. Panton-Valentine leukocidine was detected in 36% of the isolates, all MSSA. S. aureus cross-transmission between HCW and patients in the pediatric and medicine wards and the detection of identical MRSA strains among patients in two different wards evidenced the need of implementation of additional infection control measures in this hospital.
authors.affiliation: 1 Laboratório de Genética Molecular, Instituto de Tecnologia Química e Biológica (ITQB), Universidade Nova de Lisboa (UNL) , Oeiras, Portugal .
authors.forename: Teresa
authors.initials: T
authors.lastname: Conceição
authors.forename: Isabel
authors.initials: I
authors.lastname: Santos Silva
authors.forename: Hermínia
authors.initials: H
authors.lastname: de Lencastre
authors.forename: Marta
authors.initials: M
authors.lastname: Aires-de-Sousa
mesh_terms: D000349:Africa / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001427:Bacterial Toxins / Q000096:biosynthesis; D015373:Bacterial Typing Techniques; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D002999:Clone Cells; D016521:Electrophoresis, Gel, Pulsed-Field; D005098:Exotoxins / Q000096:biosynthesis; D014644:Genetic Variation; D006282:Health Personnel; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient; D062312:Islands / Q000453:epidemiology; D007956:Leukocidins / Q000096:biosynthesis; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D009296:Nasal Cavity / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin