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Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection

BACKGROUND: Healthcare-associated infections pose a potentially fatal threat to patients worldwide and Staphylococcus aureus is one of the most common causes of healthcare-associated infections. S. aureus is a common commensal pathogen and a frequent cause of bacteremia, with studies demonstrating t...

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Autores principales: Reategui Schwarz, Erika, van de Guchte, Adriana, Dupper, Amy C., Caban, Ana Berbel, Nadkarni, Devika, Fox, Lindsey, Mills, Alexandra, Obla, Ajay, Chacko, Kieran I., Oussenko, Irina, Samaroo, Flora, Polanco, Jose, Silvera, Richard, Smith, Melissa L., Patel, Gopi, Gitman, Melissa, Alburquerque, Bremy, Chung, Marilyn, Sullivan, Mitchell J., van Bakel, Harm, Altman, Deena R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9036699/
https://www.ncbi.nlm.nih.gov/pubmed/35462538
http://dx.doi.org/10.1186/s12879-022-07371-w
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author Reategui Schwarz, Erika
van de Guchte, Adriana
Dupper, Amy C.
Caban, Ana Berbel
Nadkarni, Devika
Fox, Lindsey
Mills, Alexandra
Obla, Ajay
Chacko, Kieran I.
Oussenko, Irina
Samaroo, Flora
Polanco, Jose
Silvera, Richard
Smith, Melissa L.
Patel, Gopi
Gitman, Melissa
Alburquerque, Bremy
Chung, Marilyn
Sullivan, Mitchell J.
van Bakel, Harm
Altman, Deena R.
author_facet Reategui Schwarz, Erika
van de Guchte, Adriana
Dupper, Amy C.
Caban, Ana Berbel
Nadkarni, Devika
Fox, Lindsey
Mills, Alexandra
Obla, Ajay
Chacko, Kieran I.
Oussenko, Irina
Samaroo, Flora
Polanco, Jose
Silvera, Richard
Smith, Melissa L.
Patel, Gopi
Gitman, Melissa
Alburquerque, Bremy
Chung, Marilyn
Sullivan, Mitchell J.
van Bakel, Harm
Altman, Deena R.
author_sort Reategui Schwarz, Erika
collection PubMed
description BACKGROUND: Healthcare-associated infections pose a potentially fatal threat to patients worldwide and Staphylococcus aureus is one of the most common causes of healthcare-associated infections. S. aureus is a common commensal pathogen and a frequent cause of bacteremia, with studies demonstrating that nasal and blood isolates from single patients match more than 80% of the time. Here we report on a contemporary collection of colonizing isolates from those with methicillin-resistant S. aureus (MRSA) bloodstream infections to evaluate the diversity within hosts, and detail the clinical features associated with concomitant nasal colonization. METHODS: Swabs of the bilateral anterior nares were obtained from patients diagnosed with MRSA bacteremia. A single colony culture from the blood and an average of 6 colonies from the nares were evaluated for MRSA growth. For the nares cultures, we typed multiple isolates for staphylococcal protein A (spa) and derived the clonal complexes. Demographic and clinical data were obtained retrospectively from the electronic medical record system and analysed using univariate and multivariable regression models. RESULTS: Over an 11-month period, 68 patients were diagnosed with MRSA bloodstream infection, 53 were swabbed, and 37 (70%) were colonized with MRSA in the anterior nares. We performed molecular typing on 213 nasal colonies. Spa types and clonal complexes found in the blood were also detected in the nares in 95% of the cases. We also found that 11% of patients carried more than one clone of MRSA in the nares. Male sex and history of prior hospitalization within the past 90 days increased odds for MRSA colonization. CONCLUSION: The molecular epidemiological landscape of colonization in the setting of invasive disease is diverse and defining the interplay between colonization and invasive disease is critical to combating invasive MRSA disease. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-022-07371-w.
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spelling pubmed-90366992022-04-26 Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection Reategui Schwarz, Erika van de Guchte, Adriana Dupper, Amy C. Caban, Ana Berbel Nadkarni, Devika Fox, Lindsey Mills, Alexandra Obla, Ajay Chacko, Kieran I. Oussenko, Irina Samaroo, Flora Polanco, Jose Silvera, Richard Smith, Melissa L. Patel, Gopi Gitman, Melissa Alburquerque, Bremy Chung, Marilyn Sullivan, Mitchell J. van Bakel, Harm Altman, Deena R. BMC Infect Dis Research BACKGROUND: Healthcare-associated infections pose a potentially fatal threat to patients worldwide and Staphylococcus aureus is one of the most common causes of healthcare-associated infections. S. aureus is a common commensal pathogen and a frequent cause of bacteremia, with studies demonstrating that nasal and blood isolates from single patients match more than 80% of the time. Here we report on a contemporary collection of colonizing isolates from those with methicillin-resistant S. aureus (MRSA) bloodstream infections to evaluate the diversity within hosts, and detail the clinical features associated with concomitant nasal colonization. METHODS: Swabs of the bilateral anterior nares were obtained from patients diagnosed with MRSA bacteremia. A single colony culture from the blood and an average of 6 colonies from the nares were evaluated for MRSA growth. For the nares cultures, we typed multiple isolates for staphylococcal protein A (spa) and derived the clonal complexes. Demographic and clinical data were obtained retrospectively from the electronic medical record system and analysed using univariate and multivariable regression models. RESULTS: Over an 11-month period, 68 patients were diagnosed with MRSA bloodstream infection, 53 were swabbed, and 37 (70%) were colonized with MRSA in the anterior nares. We performed molecular typing on 213 nasal colonies. Spa types and clonal complexes found in the blood were also detected in the nares in 95% of the cases. We also found that 11% of patients carried more than one clone of MRSA in the nares. Male sex and history of prior hospitalization within the past 90 days increased odds for MRSA colonization. CONCLUSION: The molecular epidemiological landscape of colonization in the setting of invasive disease is diverse and defining the interplay between colonization and invasive disease is critical to combating invasive MRSA disease. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-022-07371-w. BioMed Central 2022-04-24 /pmc/articles/PMC9036699/ /pubmed/35462538 http://dx.doi.org/10.1186/s12879-022-07371-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visithttp://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Reategui Schwarz, Erika
van de Guchte, Adriana
Dupper, Amy C.
Caban, Ana Berbel
Nadkarni, Devika
Fox, Lindsey
Mills, Alexandra
Obla, Ajay
Chacko, Kieran I.
Oussenko, Irina
Samaroo, Flora
Polanco, Jose
Silvera, Richard
Smith, Melissa L.
Patel, Gopi
Gitman, Melissa
Alburquerque, Bremy
Chung, Marilyn
Sullivan, Mitchell J.
van Bakel, Harm
Altman, Deena R.
Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection
title Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection
title_full Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection
title_fullStr Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection
title_full_unstemmed Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection
title_short Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection
title_sort everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant staphylococcus aureus bloodstream infection
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9036699/
https://www.ncbi.nlm.nih.gov/pubmed/35462538
http://dx.doi.org/10.1186/s12879-022-07371-w
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