title: Molecular epidemiology of Staphylococcus aureus in post-earthquake northern Haiti.
abstract: BACKGROUND
  Knowledge of nasal carriage is important in predicting staphylococcal infection, and no information exists regarding the endemicity of Staphylococcus aureus in Haiti.
  
  
  METHODS
  We performed a cross-sectional analysis of S. aureus nasal screening in an acute care, a subacute rehabilitation, and a community setting, with a brief medical and epidemiological history. PCR-positive S. aureus screening nasal cultures underwent molecular analysis for spa type, SCCmec type, and virulence genes (Panton-Valentine leukocidin (PVL), toxic shock syndrome toxin (TSST), and arginine catabolic mobile element (ACME)), and were evaluated for antibiotic susceptibility using commercial tests.
  
  
  RESULTS
  Overall carriage rates of 8.4% methicillin-susceptible S. aureus (MSSA) and 2.8% methicillin-resistant S. aureus (MRSA) were identified, with a high rate of tetracycline resistance. TSST and PVL genes were identified in MSSA. MRSA isolates contained no virulence markers. Unique MSSA phenotypes (i.e., linezolid-resistant, vancomycin-sensitive/daptomycin non-susceptible) were identified, as were two PVL-positive ST152 MSSA colonization isolates, previously geographically limited to Africa.
  
  
  CONCLUSIONS
  We found a low S. aureus carriage rate with complete vancomycin susceptibility and high tetracycline resistance, which has important public health implications with regard to treatment. Additionally, the finding of PVL-positive MSSA isolates, including the expansion of a previously described limited 'divergent' clone, ST152, warrants further evaluation.
authors.affiliation: Department of Medicine, Jersey Shore University Medical Center, 1945 State Route 33, Ackerman 326, Neptune City, NJ 07753, USA; Public Health Research Institute, Rutgers University, Newark, New Jersey, USA. Electronic address: mrosenthal@meridianhealth.com.
authors.forename: Marnie E
authors.initials: ME
authors.lastname: Rosenthal
authors.affiliation: Public Health Research Institute, Rutgers University, Newark, New Jersey, USA.
authors.forename: Jose
authors.initials: J
authors.lastname: Mediavilla
authors.affiliation: Public Health Research Institute, Rutgers University, Newark, New Jersey, USA.
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.affiliation: Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Julian
authors.initials: J
authors.lastname: Sonnenfeld
authors.affiliation: Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Logan
authors.initials: L
authors.lastname: Pierce
authors.affiliation: Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Shannon
authors.affiliation: Tufts University School of Medicine, Boston, Massachusetts, USA; Tufts Medical Center, Boston, Massachusetts, USA.
authors.forename: Helen
authors.initials: H
authors.lastname: Boucher
authors.affiliation: Tufts Medical Center, Boston, Massachusetts, USA; St. Elizabeth's Medical Center, Steward Healthcare, Brighton, Massachusetts, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Pearlmutter
authors.affiliation: Public Health Research Institute, Rutgers University, Newark, New Jersey, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Kreiswirth
authors.affiliation: Office of Clinical Research, Jersey Shore University Medical Center, Neptune, New Jersey, USA.
authors.forename: Yen-Hong
authors.initials: YH
authors.lastname: Kuo
authors.affiliation: Hôpital Sacré Coeur, Milot, Haiti.
authors.forename: Harold
authors.initials: H
authors.lastname: Previl
authors.affiliation: Department of Pathology, Jersey Shore University Medical Center, Neptune, New Jersey, USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Rojtman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001427:Bacterial Toxins / Q000235:genetics; D003430:Cross-Sectional Studies; D055866:Earthquakes; D004768:Enterotoxins / Q000235:genetics; D005098:Exotoxins / Q000235:genetics; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D007956:Leukocidins / Q000235:genetics; D008297:Male; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000821:virology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D018089:Superantigens / Q000235:genetics; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
chemical_list: D001427:Bacterial Toxins; D004768:Enterotoxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D018089:Superantigens; D037521:Virulence Factors; C030107:enterotoxin F, Staphylococcal
keywords: Epidemiology; Haiti; Molecular epidemiology; Staphylococcus aureus