Prevalence and characteristics of methicillin‐resistant Staphylococcus aureus in community residents of Japan

Abstract

BackgroundTo implement effective precautions to avoid methicillin‐resistant Staphylococcus aureus (MRSA) nosocomial infections, it is important to clarify when, how, and from whom MRSA was transmitted to the patients. However, MRSA strains obtained from outpatient population were not analyzed, and the transmission routes of MRSA in the community are not completely understood. The purpose of this study was to clarify whether MRSA is spreading in community settings or whether MRSA transmission still occurs only in healthcare institutions.MethodsSurveillance cultures of 1274 residents living in a community were performed in two different areas, Kochi and Osaka prefectures of Japan. All isolated MRSA strains were evaluated using multilocus sequence typing (MLST) to clarify the transmission routes of MRSA. The results were compared with those of inpatients. Moreover, written questionnaires and medical records were analyzed.ResultsAnalysis of surveillance cultures from residents living in the community in Japan revealed an MRSA colonization rate of 0.94%. The proportion of MRSA to S. aureus colonization was 2.6% in the 310 residents, which was significantly lower than in the 393 hospitalized patients (63.1%; P < .0001). MRSA strains in residents are different from the endemic strains in the hospitalized patients. Previous hospital admission is a risk factor for MRSA infection of the endemic strain in hospital.ConclusionsMethicillin‐resistant Staphylococcus aureus colonization in community setting is rare in Japan. MLST results suggest that some MRSA strains are moving to the community through previous hospital admissions; however, MRSA is not spreading in community settings.

Prevalence and characteristics of methicillin‐resistant Staphylococcus aureus colonization among healthcare professionals in a university hospital in Japan

“…Methicillin‐resistant Staphylococcus aureus colonization was investigated in 45 healthcare professionals. The results were compared with previous MRSA surveillance data and are summarized in Table . The proportion of MRSA colonization was significantly higher among healthcare professionals (11.1%) than community residents (0.72%; P < 0.0001) or admission case (2.5%; P = 0.018).…”

“…Multilocus sequence typing analysis revealed that five isolates from healthcare professionals consisted of two ST8 and three ST764 isolates. These results were combined with previous MRSA surveillance data and are summarized in Table . Both ST8 and ST764 strains were isolated from residents, admission cases, hospitalized patients, and healthcare professionals.…”

“…Culture of bilateral anterior naris samples obtained from all participants was performed. Isolation and identification of MRSA, and multilocus sequence typing (MLST) analysis were performed as described previously …”

Association Between Length of Residence and Prevalence of Mrsa Colonization Among Residents in Geriatric Long-term Care Facilities

“…[45] The prevalence of MRSA in the Japanese general population is estimated to be ≤ 5%. [46][47][48]; however, this prevalence might be higher among elderly adults owing to frailty, in comparison with younger people. [49] Furthermore, regional MRSA epidemics of community-acquired strains have recently occurred in Japan, which might affect MRSA prevalence.…”

Prevalence of nasal carriage of MRSA in diabetic patients attending the outpatient department

“…For example, the prevalence of communityassociated MRSA infection in Japan, Germany, Turkey, Taiwan, and Malta was found to be 0.94%, 1.2%, 1.2%, 1 3.8%, 1 and 8.81% 1 respectively. [8][9][10][11][12] This variation of nasal carriage rate of S. aureus in studies might be due to difference in the characteristics of the study population, quality of sampling, culturing techniques, geographical distribution, and diagnostic techniques. 13 A previous study reported an MRSA colonization rate in diabetics as 10.2%, whereas in another study it was 19% in diabetics on hemodialysis.…”