Molecular Epidemiology of Staphylococcus aureus in the General Population in Northeast Germany: Results of the Study of Health in Pomerania (SHIP-TREND-0).
Population-based studies on Staphylococcus aureus nasal colonization are scarce. We examined the prevalence, resistance, and molecular diversity of S. aureus in the general population in Northeast Germany. Nasal swabs were obtained from 3,891 adults in the large-scale population-based Study of Health in Pomerania (SHIP-TREND). Isolates were characterized using spa genotyping, as well as antibiotic resistance and virulence gene profiling. We observed an S. aureus prevalence of 27.2%. Nasal S. aureus carriage was associated with male sex and inversely correlated with age. Methicillin-resistant S. aureus (MRSA) accounted for 0.95% of the colonizing S. aureus strains. MRSA carriage was associated with frequent visits to hospitals, nursing homes, or retirement homes within the previous 24 months. All MRSA strains were resistant to multiple antibiotics. Most MRSA isolates belonged to the pandemic European hospital-acquired MRSA sequence type 22 (HA-MRSA-ST22) lineage. We also detected one livestock-associated MRSA ST398 (LA-MRSA-ST398) isolate, as well as six livestock-associated methicillin-susceptible S. aureus (LA-MSSA) isolates (clonal complex 1 [CC1], CC97, and CC398). spa typing revealed a diverse but also highly clonal S. aureus population structure. We identified a total of 357 spa types, which were grouped into 30 CCs or sequence types. The major seven CCs (CC30, CC45, CC15, CC8, CC7, CC22, and CC25) included 75% of all isolates. Virulence gene patterns were strongly linked to the clonal background. In conclusion, MSSA and MRSA prevalences and the molecular diversity of S. aureus in Northeast Germany are consistent with those of other European countries. The detection of HA-MRSA and LA-MRSA within the general population indicates possible transmission from hospitals and livestock, respectively, and should be closely monitored.
Department of Immunology, University Medicine Greifswald, Greifswald, Germany.
Silva
S
Holtfreter
Department of Immunology, University Medicine Greifswald, Greifswald, Germany.
Dorothee
D
Grumann
Friedrich-Loeffler Institute for Medical Microbiology, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany.
Veronika
V
Balau
Friedrich-Loeffler Institute for Medical Microbiology, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany.
Annette
A
Barwich
Department of Immunology, University Medicine Greifswald, Greifswald, Germany.
Julia
J
Kolata
Friedrich-Loeffler Institute for Medical Microbiology, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany.
André
A
Goehler
Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany.
Stefan
S
Weiss
Department of Restorative Dentistry, Periodontology, Endodontology and Pedodontics, University Medicine Greifswald, Greifswald, Germany.
Birte
B
Holtfreter
Department of Immunology, University Medicine Greifswald, Greifswald, Germany.
Stephanie S
SS
Bauerfeind
Department of Immunology, University Medicine Greifswald, Greifswald, Germany.
Paula
P
Döring
Department of Immunology, University Medicine Greifswald, Greifswald, Germany.
Erika
E
Friebe
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Nicole
N
Haasler
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Kristin
K
Henselin
Friedrich-Loeffler Institute for Medical Microbiology, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany.
Katrin
K
Kühn
Department of Immunology, University Medicine Greifswald, Greifswald, Germany.
Sophie
S
Nowotny
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Dörte
D
Radke
Friedrich-Loeffler Institute for Medical Microbiology, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany.
Katrin
K
Schulz
Department of Immunology, University Medicine Greifswald, Greifswald, Germany.
Sebastian R
SR
Schulz
Department of Immunology, University Medicine Greifswald, Greifswald, Germany.
Patricia
P
Trübe
Department of Immunology, University Medicine Greifswald, Greifswald, Germany.
Chi Hai
CH
Vu
Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany.
Birgit
B
Walther
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Susanne
S
Westphal
Robert Koch Institute, Wernigerode Branch, National Reference Center for Staphylococci, Wernigerode, Germany.
Christiane
C
Cuny
Robert Koch Institute, Wernigerode Branch, National Reference Center for Staphylococci, Wernigerode, Germany.
Wolfgang
W
Witte
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Henry
H
Völzke
Department of Psychiatry und Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
Hans Jörgen
HJ
Grabe
Department of Restorative Dentistry, Periodontology, Endodontology and Pedodontics, University Medicine Greifswald, Greifswald, Germany.
Thomas
T
Kocher
Friedrich-Loeffler Institute for Medical Microbiology, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany.
Ivo
I
Steinmetz
Department of Immunology, University Medicine Greifswald, Greifswald, Germany broeker@uni-greifswald.de.
Barbara M
BM
Bröker
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D016000:Cluster Analysis; D015331:Cohort Studies; D024881:Drug Resistance, Bacterial; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D060005:Genotyping Techniques; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D058889:Molecular Typing; D009296:Nasal Cavity / Q000382:microbiology*; D015995:Prevalence; D012737:Sex Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013205:Staphylococcal Protein A / Q000235:genetics; D013211:Staphylococcus aureus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
D013205:Staphylococcal Protein A; D037521:Virulence Factors