title: Methicillin-resistant Staphylococcus aureus in public transportation vehicles (buses): another piece to the epidemiologic puzzle.
abstract: BACKGROUND
  Little is known about the occurrence and epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in public transportation in the United States. This research sought to determine the background prevalence and phenotypic and genotypic characteristics of MRSA strains circulating on buses from a large, metropolitan transportation agency.
  
  
  METHODS
  Electrostatic wipes were used to collect 237 surface samples from 40 buses randomly selected from July-October 2010. Six samples were collected from each bus immediately postservice and before any cleaning and disinfection. Positive isolates were analyzed for antibiotic resistance, staphylococcal cassette chromosome mec (SCCmec) type, and pulsed-field gel electrophoresis; and potential epidemiologic factors were examined.
  
  
  RESULTS
  Of the buses, 68% (27/40) were contaminated with S aureus, and 63% (25/40) were contaminated with MRSA. Seats and seat rails were the surfaces most frequently contaminated, followed by the back door and stanchions. Most (62.9%) of the MRSA isolates were classified as community-associated MRSA clones (SCCmec type IV), and 22.9% were health care-associated MRSA clones (SCCmec type II). Of the MRSA strains, 65% (5/20) were multidrug resistant.
  
  
  CONCLUSIONS
  MRSA was frequently isolated from commonly touched surfaces in buses serving both hospital and community routes. Phenotypic and genotypic analysis demonstrated that buses may be effective mixing vessels for MRSA strains of both community and health care-associated origin.
authors.affiliation: Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH.
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Lutz
authors.affiliation: Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH.
authors.forename: Joany
authors.initials: J
authors.lastname: van Balen
authors.affiliation: Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH.
authors.forename: John Mac
authors.initials: JM
authors.lastname: Crawford
authors.affiliation: Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH.
authors.forename: John R
authors.initials: JR
authors.lastname: Wilkins
authors.affiliation: Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH; Department of Food Science and Technology, The Ohio State University, Columbus, OH.
authors.forename: Jiyoung
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH.
authors.forename: Rocio C
authors.initials: RC
authors.lastname: Nava-Hoet
authors.affiliation: Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH; Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH. Electronic address: hoet.1@osu.edu.
authors.forename: Armando E
authors.initials: AE
authors.lastname: Hoet
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006801:Humans; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance / Q000235:genetics; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D018986:Motor Vehicles; D010641:Phenotype; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin
keywords: Methicillin-resistant Staphylococcus aureus; Public transportation; Surface contamination