title: Carriage niches and molecular epidemiology of Staphylococcus lugdunensis and methicillin-resistant S. lugdunensis among patients undergoing long-term renal replacement therapy.
abstract: We collected nasal, axilla, and groin swabs from 252 adult patients from 2 nephrology centers in Hong Kong. Staphylococcus lugdunensis carriage was detected in 51.6% patients (groin, 39.3%; axilla, 19.8%; nose, 17.9%). The carriage rates of methicillin-sensitive S. lugdunensis and methicillin-resistant S. lugdunensis (MRSL) were 46.0% and 8.3%, respectively. Independent risk factors for S. lugdunensis carriage included male sex (odds ratio [OR], 4.4), hemodialysis (OR, 2.2), and aged 18-50years (OR, 2.4). The isolates belonged to 10 pulsotype clusters (n=129) and 8 singletons (n=8). All MRSL and most gentamicin- and tetracycline-resistant strains were found in a predominating sequence type 3 clone, designated HKU1, which accounted for 51.8% of all colonizing S. lugdunensis strains. The 21 MRSL isolates had SCCmec type V (n=18), type IV (n=2), and type I (n=1). The finding highlights the potential for dissemination of multidrug resistance through successful S. lugdunensis clones.
authors.affiliation: Carol Yu Centre for Infection and Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China. Electronic address: plho@hkucc.hku.hk.
authors.forename: Pak-Leung
authors.initials: PL
authors.lastname: Ho
authors.affiliation: Carol Yu Centre for Infection and Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Sammy Man-Him
authors.initials: SM
authors.lastname: Leung
authors.affiliation: Carol Yu Centre for Infection and Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Kin-Hung
authors.initials: KH
authors.lastname: Chow
authors.affiliation: Department of Clinical Pathology, Kwong Wah Hospital, Hong Kong, China.
authors.forename: Cindy Wing-Sze
authors.initials: CW
authors.lastname: Tse
authors.affiliation: Carol Yu Centre for Infection and Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Vincent Chi-Chung
authors.initials: VC
authors.lastname: Cheng
authors.affiliation: Carol Yu Centre for Infection and Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Herman
authors.initials: H
authors.lastname: Tse
authors.affiliation: Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China.
authors.forename: Siu-Ka
authors.initials: SK
authors.lastname: Mak
authors.affiliation: Department of Medicine, Tung Wah Hospital, Hong Kong, China.
authors.forename: Wai-Kei
authors.initials: WK
authors.lastname: Lo
mesh_terms: D000293:Adolescent; D000328:Adult; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D017720:Molecular Epidemiology; D058889:Molecular Typing; D017582:Renal Replacement Therapy; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D057787:Staphylococcus lugdunensis / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D055815:Young Adult
keywords: Antimicrobial resistance; Methicillin resistance; Molecular epidemiology; Renal replacement therapy; Staphylococcus lugdunensis