title: Staphylococcus aureus from the German general population is highly diverse.
abstract: OBJECTIVE
  This prospective cohort study evaluates colonization dynamics and molecular characteristics of methicillin-susceptible and - resistant Staphylococcus aureus (MSSA/MRSA) in a German general population.
  
  
  METHODS
  Nasal swabs of 1878 non-hospitalized adults were screened for S. aureus. Participants were screened thrice in intervals of 6-8 months. Isolates were characterized by spa and agr typing, mecA and mecC possession, respectively, and PCRs targeting virulence factors.
  
  
  RESULTS
  40.9% of all participants carried S. aureus at least once while 0.7% of the participants carried MRSA (mainly spa t011). MSSA isolates (n=1359) were associated with 331 different spa types; t084 (7.7%), t091 (6.1%) and t012 (71, 5.2%) were predominant. Of 206 participants carrying S. aureus at all three sampling time points, 14.1% carried the same spa type continuously; 5.3% carried different spa types with similar repeat patterns, but 80.6% carried S. aureus with unrelated spa types. MSSA isolates frequently harboured genes encoding enterotoxins (sec: 16.6%, seg: 63.1%, sei: 64.5%) and toxic shock syndrome toxin (tst: 17.5%), but rarely Panton-Valentine leukocidin (lukS-PV/lukF-PV: 0.2%).
  
  
  CONCLUSIONS
  MSSA colonizing human nares in the community are clonally highly diverse. Among those constantly carrying S. aureus, clonal lineages changed over time. The proportion of persistent S. aureus carriers was lower than reported elsewhere.
authors.affiliation: University Hospital Münster, Institute of Medical Microbiology, 48149 Münster, Germany. Electronic address: kbecker@uni-muenster.de.
authors.forename: Karsten
authors.initials: K
authors.lastname: Becker
authors.affiliation: University Hospital Münster, Institute of Medical Microbiology, 48149 Münster, Germany.
authors.forename: Frieder
authors.initials: F
authors.lastname: Schaumburg
authors.affiliation: University Heilbronn, GECKO Institute of Medicine, Informatics and Economy, 74081 Heilbronn, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Fegeler
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Medical Microbiology, 9700 Groningen, The Netherlands.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Friedrich
authors.affiliation: University Hospital Münster, Institute of Medical Microbiology, 48149 Münster, Germany.
authors.forename: Robin
authors.initials: R
authors.lastname: Köck
mesh_terms: D000328:Adult; D001426:Bacterial Proteins / Q000235:genetics; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D058889:Molecular Typing; D009297:Nasal Mucosa / Q000382:microbiology; D046915:Penicillin-Binding Proteins / Q000235:genetics; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013205:Staphylococcal Protein A / Q000235:genetics; D013211:Staphylococcus aureus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D015534:Trans-Activators / Q000235:genetics; D037521:Virulence Factors / Q000235:genetics
chemical_list: C095698:Agr protein, Staphylococcus aureus; D001426:Bacterial Proteins; D046915:Penicillin-Binding Proteins; D013205:Staphylococcal Protein A; D015534:Trans-Activators; D037521:Virulence Factors; C487789:mecA protein, Staphylococcus aureus
keywords: CC398; Colonization; Epidemiology; Livestock; MRSA; Staphylococcus aureus