Staphylococcus aureus Colonization and Strain Type at Various Body Sites among Patients with a Closed Abscess and Uninfected Controls at U.S. Emergency Departments

Valerie S Albrecht; Brandi M Limbago; Gregory J Moran; Anusha Krishnadasan; Rachel J Gorwitz; Linda K McDougal; David A Talan; EMERGEncy ID NET Study Group

doi:10.1128/JCM.01371-15

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Staphylococcus aureus Colonization and Strain Type at Various Body Sites among Patients with a Closed Abscess and Uninfected Controls at U.S. Emergency Departments

Journal article

Open access

Peer reviewed

Staphylococcus aureus Colonization and Strain Type at Various Body Sites among Patients with a Closed Abscess and Uninfected Controls at U.S. Emergency Departments

Valerie S Albrecht, Brandi M Limbago, Gregory J Moran, Anusha Krishnadasan, Rachel J Gorwitz, Linda K McDougal, David A Talan and EMERGEncy ID NET Study Group

Journal of clinical microbiology, Vol.53(11), pp.3478-3484

11/2015

DOI: 10.1128/JCM.01371-15

PMCID: PMC4609677

PMID: 26292314

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Abstract

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a prevalent cause of skin and soft tissue infections (SSTI), but the association between CA-MRSA colonization and infection remains uncertain. We studied the carriage frequency at several body sites and the diversity of S. aureus strains from patients with and without SSTI. Specimens from the nares, throat, rectum, and groin of case subjects with a closed skin abscess (i.e., without drainage) and matched control subjects without a skin infection (n = 147 each) presenting to 10 U.S. emergency departments were cultured using broth enrichment; wound specimens were cultured from abscess cases. Methicillin resistance testing and spa typing were performed for all S. aureus isolates. S. aureus was found in 85/147 (57.8%) of abscesses; 49 isolates were MRSA, and 36 were methicillin-susceptible S. aureus (MSSA). MRSA colonization was more common among cases (59/147; 40.1%) than among controls (27/147; 18.4%) overall (P < 0.001) and at each body site; no differences were observed for MSSA. S. aureus-infected subjects were usually (75/85) colonized with the infecting strain; among MRSA-infected subjects, this was most common in the groin. The CC8 lineage accounted for most of both infecting and colonizing isolates, although more than 16 distinct strains were identified. Nearly all MRSA infections were inferred to be USA300. There was more diversity among colonizing than infecting isolates and among those isolated from controls versus cases. CC8 S. aureus is a common colonizer of persons with and without skin infections. Detection of S. aureus colonization, and especially MRSA, may be enhanced by extranasal site culture.

Abscess - microbiology

Adolescent

Adult

Aged

Aged, 80 and over

Carrier State

Community-Acquired Infections - microbiology

Comorbidity

Emergency Service, Hospital

Female

Groin - microbiology

Humans

Male

Methicillin-Resistant Staphylococcus aureus - classification

Methicillin-Resistant Staphylococcus aureus - isolation & purification

Methicillin-Resistant Staphylococcus aureus - pathogenicity

Middle Aged

Nasal Cavity - microbiology

Pharynx - microbiology

Skin - microbiology

Soft Tissue Infections - microbiology

Staphylococcal Skin Infections - microbiology

Surveys and Questionnaires

United States

Young Adult

Details

Title: Subtitle: Staphylococcus aureus Colonization and Strain Type at Various Body Sites among Patients with a Closed Abscess and Uninfected Controls at U.S. Emergency Departments
Creators: Valerie S Albrecht - aDivision of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Brandi M Limbago - aDivision of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Gregory J Moran - Olive View-UCLA Medical Center
Anusha Krishnadasan - Olive View-UCLA Medical Center
Rachel J Gorwitz - dDivision of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Linda K McDougal - aDivision of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
David A Talan - Olive View-UCLA Medical Center
EMERGEncy ID NET Study Group
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.53(11), pp.3478-3484
DOI: 10.1128/JCM.01371-15
PMID: 26292314
PMCID: PMC4609677
NLM abbreviation: J Clin Microbiol
ISSN: 0095-1137
eISSN: 1098-660X
Grant note: U01 CK000176 / NCEZID CDC HHS
Language: English
Date published: 11/2015
Academic Unit: Emergency Medicine; Internal Medicine
Record Identifier: 9984296981602771

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