title: Nasal carriage of coagulase positive staphylococci in patients of a Primary-Healthcare-Center: genetic lineages and resistance and virulence genes.
abstract: BACKGROUND
  Staphylococcus aureus and Staphylococcus pseudintermedius are highly important due to their capacity for producing diseases in humans and animals, respectively. The aim of the study was to investigate and characterize the coagulase positive Staphylococcus (CoPS) carriage in a Primary Healthcare Center population.
  
  
  METHODS
  Nasal swabs were obtained from 281 non-infectious patients. The CoPS isolates recovered were typed, and their resistance phenotype and genotype, as well as their virulence profiles, were analyzed.
  
  
  RESULTS
  CoPS isolates were recovered from 56/281 patients (19.9%). Fifty-five were S. aureus (19.6%), 54 were methicillin susceptible (MSSA) and one was methicillin resistant (MRSA). The remaining isolate was S. pseudintermedius (0.4%). A high diversity of spa-types (n=40) was detected, with 6 of them being new ones. The multi-locus-sequence-typing of 13 MSSA and one MRSA selected isolates was performed and the STs detected were: ST8, ST15, ST30, ST34, ST121, ST146, ST398, ST554, ST942, ST2499, and ST2500 (the last two STs being new). One MSSA isolate was typed as t1197-ST398-(Clonal complex)CC398. The MRSA isolate was typed as t002-ST146-CC5-SCCmec-IVc, and exhibited a multiresistance phenotype. The detected resistances were: penicillin (76%), macrolides (7%), tetracycline (7%), trimethoprim-sulfamethoxazole (7%), quinolones (7%), and lincosamides (5%). Five isolates contained lukF/lukS-PV genes, 17 tst gene, one eta gene, and two etb gene. The S. pseudintermedius isolate presented a new spa-type (t57) (belonging to a new ST180) and the genes lukS/F-I, siet, se-int, and expB.
  
  
  CONCLUSIONS
  A high genetic diversity of S. aureus was detected. Mention must be made of the identification of MSSA CC398 and S. pseudintermedius isolates in two patients, one of them with animal contact. The detection of the genes lukF/lukS-PV and tst should be noted.
authors.affiliation: Área Bioquímica y Biología Molecular, Universidad de La Rioja, Logrono, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Lozano
authors.affiliation: Ambulatorio Área Básica de Salud Balàfia-Pardinyes-Secà, Lérida, Spain.
authors.forename: Alba
authors.initials: A
authors.lastname: Marí
authors.affiliation: Unidad de Microbiología, Hospital Royo Villanova, Zaragoza, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Aspiroz
authors.affiliation: Área Bioquímica y Biología Molecular, Universidad de La Rioja, Logrono, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Gómez-Sanz
authors.affiliation: Área Bioquímica y Biología Molecular, Universidad de La Rioja, Logrono, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Ceballos
authors.affiliation: Unidad de Microbiología, Hospital Royo Villanova, Zaragoza, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Fortuño
authors.affiliation: Unidad Funcional de Infección Nosocomial, Hospital Universitario Arnau de Vilanova, Lérida, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Barcenilla
authors.affiliation: Unidad Funcional de Infección Nosocomial, Hospital Universitario Arnau de Vilanova, Lérida, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Jover-Sáenz
authors.affiliation: Área Bioquímica y Biología Molecular, Universidad de La Rioja, Logrono, Spain. Electronic address: carmen.torres@unirioja.es.
authors.forename: Carmen
authors.initials: C
authors.lastname: Torres
mesh_terms: D015373:Bacterial Typing Techniques / Q000379:methods; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D003153:Community Health Services / Q000706:statistics & numerical data; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D005798:Genes, Bacterial; D014644:Genetic Variation; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D009296:Nasal Cavity / Q000382:microbiology*; D011320:Primary Health Care; D013030:Spain / Q000453:epidemiology; D013045:Species Specificity; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D014774:Virulence / Q000235:genetics
keywords: CC398; LPV; MRSA; MSSA; Nasal carriage; PVL; Portador nasal; SARM; SASM; Staphylococcus aureus; Staphylococcus pseudintermedius; TSST-1