The Environment as an Unrecognized Reservoir for Community-Associated Methicillin Resistant Staphylococcus aureus USA300: A Case-Control Study

• DOI: 10.1371/journal.pone.0022407
• Publication Date: 2011-07-26T20:53:06Z
• Authors: Anne-Catrin Uhlemann; Justin Knox; Maureen Miller; Cory Hafer; Glenny Vasquez; Megan Ryan; Peter Vavagiakis; Qiuhu Shi; Franklin D. Lowy
• Keywords: Adult; Male; Methicillin-Resistant Staphylococcus aureus; 0301 basic medicine; Adolescent; Science; Colony Count, Microbial; Nose; 03 medical and health sciences; Recurrence; Risk Factors; Environmental Microbiology; Humans; Child; Household Articles; Aged; Disease Reservoirs; Q; R; Environmental Exposure; Middle Aged; 3. Good health; Community-Acquired Infections; Case-Control Studies; Child, Preschool; Medicine; Female; Research Article

Background Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are spreading, but the source of in non-epidemic settings remains poorly defined. Methods We carried out a community-based, case-control study investigating socio-demographic risk factors and infectious reservoirs associated with MRSA infections. Case patients presented CA-MRSA to New York hospital. Age-matched controls without were randomly selected from hospital's Dental Clinic patient population. During home visit, case control subjects completed questionnaire, nasal swabs collected index respondents household members standardized environmental surfaces swabbed. Genotyping was performed on S. isolates. Results enrolled 95 subjects. Cases more frequently reported diabetes mellitus higher number skin among members. Among households, 53 (56%) environmentally contaminated aureus, compared 36 (38%) households (p = .02). detected fomites 30 (32%) 5 (5%; p<.001) households. More patients, 20 (21%) nasally colonized than indexes, 2 (2%; p<.001). In subgroup analysis, clinical isolate (predominantly USA300), commonly recurrent (16/36, 44%) those (14/58, 24%, p .04). Conclusions The frequency contamination general particular implicates this as potential reservoir for recolonization increased infection. Environmental colonization may contribute community spread epidemic strains such USA300.