Molecular Epidemiology of Staphylococcus aureus and MRSA in Bedridden Patients and Residents of Long-Term Care Facilities

• Published in: Antibiotics (Basel) Vol. 11; no. 11; p. 1526
• Main Authors: Silva, Lucas Porangaba, Fortaleza, Carlos Magno Castelo Branco, Teixeira, Nathalia Bibiana, Silva, Luís Thadeo Poianas, de Angelis, Carolina Destro, Ribeiro de Souza da Cunha, Maria de Lourdes
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-11-2022; MDPI
• Subjects: Antimicrobial resistance; bedridden patients; Comorbidity; Disease; elderly population; Electrophoresis; Epidemics; Epidemiology; Gel electrophoresis; Gender; Health risks; Immobilization; Institutionalization; Long term health care; Long-term care; long-term care facility; Males; MecA protein; Methicillin; Microorganisms; molecular epidemiology; Mortality; MRSA; Multidrug resistance; Multidrug resistant organisms; Multilocus sequence typing; Multivariate analysis; Nursing homes; Older people; Oropharynx; Pandemics; Patients; Public health; Pulsed-field gel electrophoresis; Rectum; Regression analysis; Risk analysis; Risk factors; Staphylococcus aureus; Staphylococcus infections; Virulence; molecular epidemiology; elderly population; long-term care facility; bedridden patients; Staphylococcus aureus; MRSA
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics11111526

At present, multidrug-resistant microorganisms are already responsible for community-acquired infections. Methicillin-resistant Staphylococcus aureus (MRSA) poses a serious public health risk worldwide because of the rapid spread and diversification of pandemic clones that are characterized by increasing virulence and antimicrobial resistance. The aim of this study was to identify the prevalence and factors associated with nasal, oral and rectal carriage of S. aureus and MRSA in bedridden patients and residents of long-term care facilities for the elderly (LTCFs) in Botucatu, SP, Brazil. Nasal, oral and rectal swab isolates obtained from 226 LTCF residents or home-bedridden patients between 2017 and 2018 were submitted to susceptibility testing, detection of the mecA gene, SCCmec characterization, and molecular typing by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Logistic regression analysis was used to identify risk factors associated with the presence of S. aureus and MRSA. The prevalence of S. aureus and MRSA was 33.6% (n = 76) and 8% (n = 18), respectively. At the nine LTCFs studied, the prevalence of S. aureus ranged from 16.6% to 85.7% and that of MRSA from 13.3% to 25%. Living in an LTCF, male gender, a history of surgeries, and a high Charlson Comorbidity Index score were risk factors associated with S. aureus carriage, while MRSA carriage was positively associated with male gender. This study showed a high prevalence of S. aureus among elderly residents of small (<15 residents) and medium-sized (15−49 residents) LTCFs and a higher prevalence of MRSA in the oropharynx.