Background
Methods
Bacterial isolates
Pulsed-field gel electrophoresis (PFGE)
spa types, multi-locus sequence typing (MLST), agrspecificity groups, and virulence genes
Bacterial growth rate
Antibiotic susceptibility testing
Clinical data and statistical analysis
Results
Genetic profiling of nasal carriage and community-onset infection isolates
S. aureusinfections and clinical characteristics
Category (No.) | PFGE cluster:CC#
| MLST* | Diagnosis#
| |
---|---|---|---|---|
Superficial infection | Deep infection | |||
Community-associated infection (24) | A:45 (1) | ST508 | Cellulitis | |
B:6 (1) | ST6 | Osteomyelitis | ||
C:7 (3) | ST7 | Cellulitis (1) | Pneumonia (1), spondylitis (1) | |
C:12 (3) | ST12 | Necrotizing mediastinitis (1), acute cholecystitis (1), spondylitis (1) | ||
D:1 (5) | ST188 | Urinary tract infection (1) | Spondylitis (1), paraspinal abscess (1), septic arthritis (1), pneumonia (1) | |
E:97 (3) | ST97 | Cellulitis (1) | Septic arthritis (1), endocarditis (1) | |
G:15 (2) | ST15 | Cellulitis (2) | ||
J:398 (1) | ST291 | Septic arthritis | ||
N:59 (2) | ST59 | Cellulitis (2) | ||
P:8 (1) | ST630 | Epiglotitis with septicemia | ||
Q (1) | NT | Pneumonia | ||
R (1) | NT | Pneumonia | ||
Healthcare-associated community-onset infection (10) | C:6 (1) | ST6 | Pneumonia | |
C:7 (3) | ST7 | Wound (2) | CNS infection (1) | |
C:12 (1) | ST12 | Wound | ||
D:1 (2) | ST188 | Epidermal cyst (1), wound (1) | ||
E:97 (1) | ST97 | Septic arthritis | ||
G:15 (1) | ST15 | Bacteremia | ||
N:59 (1) | ST59 | Wound |
Distribution of clonal lineages among nasal carriage and infection isolates
agrspecificity groups and virulence gene profiles
Virulence gene | Carriage | Infection | |||||
---|---|---|---|---|---|---|---|
N | (%) | N | (%) | OR | 99% CI |
P
| |
fnbA
| 91 | 91 | 33 | 97.1 | 3.264 | 0.206-51.833 | 0.271 |
cna
| 58 | 58 | 14 | 41.2 | 0.507 | 0.179-1.432 | 0.092 |
sdrC
| 100 | 100 | 34 | 100 | |||
sdrD
| 59 | 59 | 20 | 58.8 | 0.993 | 0.351-2.806 | 0.986 |
sdrE
| 72 | 72 | 24 | 70.6 | 0.933 | 0.303-2.879 | 0.875 |
bbp
| 23 | 23 | 2 | 5.9 | 0.209 | 0.029-1.507 | 0.041 |
icaA
| 97 | 97 | 34 | 100 | |||
sea
| 14 | 14 | 6 | 17.6 | 1.316 | 0.332-5.212 | 0.607 |
seb
| 29 | 29 | 6 | 17.6 | 0.525 | 0.144-1.907 | 0.198 |
sec
| 26 | 26 | 4 | 11.8 | 0.379 | 0.085-1.686 | 0.094 |
sed
| 0 | 0 | 0 | 0 | |||
see
| 0 | 0 | 0 | 0 | |||
seg
|
65
|
65
|
2
|
5.9
|
0.034
|
0.005-0.237
|
<0.001
|
seh
| 37 | 37 | 12 | 35.3 | 0.929 | 0.319-2.700 | 0.858 |
sei
|
64
|
64
|
6
|
17.6
|
0.121
|
0.034-0.432
|
<0.001
|
sej
| 0 | 0 | 0 | 0 | |||
sem
|
66
|
66
|
2
|
5.9
|
0.032
|
0.005-0.227
|
<0.001
|
sen
|
67
|
67
|
1
|
2.9
|
0.015
|
0.001-0.216
|
<0.001
|
seo
|
66
|
66
|
2
|
5.9
|
0.032
|
0.005-0.227
|
<0.001
|
tst
|
31
|
31
|
1
|
2.9
|
0.067
|
0.005-0.977
|
0.009
|
eta
| 20 | 20 | 1 | 2.9 | 0.121 | 0.008-1.790 | 0.044 |
etb
| 12 | 12 | 0 | 0 | |||
lukE
-
lukD
|
69
|
69
|
32
|
94.1
|
7.188
|
1.014-50.947
|
0.009
|
lukS-lukF
| 7 | 7 | 3 | 8.8 | 1.286 | 0.201-8.226 | 0.727 |
hla
| 97 | 97 | 33 | 97.1 | 1.021 | 0.050-20.899 | 0.986 |
hlb
| 31 | 31 | 8 | 23.5 | 0.685 | 0.210-2.231 | 0.409 |
hld
| 100 | 100 | 34 | 100 | |||
hlg
|
34
|
34
|
2
|
5.9
|
0.121
|
0.017-0.857
|
0.005
|
hlg2
|
63
|
63
|
30
|
88.2
|
4.405
|
1.012-19.181
|
0.009
|
Bacterial growth rate
Antibiotic resistance profiles
Antimicrobial agent | Carriage (n=100) | Infection (n=34) |
P
|
---|---|---|---|
N (%) | N (%) | ||
Chloramphenicol | 10 (10%) | 3 (9%) | 1 |
Ciprofloxacin | 0 | 0 | |
Clindamycin | 13 (13%) | 3 (9%) | 0.56 |
Erythromycin | 46 (46%) | 3 (9%) |
<0.01
|
Gentamicin | 0 | 2 (6%) | 0.07 |
Linezolid | 0 | 0 | |
Oxacillin | 0 | 0 | |
Penicillin | 92 (92%) | 31 (91%) | 0.73 |
QDA | 0 | 0 | |
Rifampin | 1 (1%) | 0 | 1 |
SXT | 0 | 0 | |
Teicoplanin | 0 | 0 | |
Tetracycline | 36 (36%) | 14 (41%) | 0.92 |
Vancomycin | 0 | 0 |