h Two screening methods to detect staphylococcal colonization in humans were compared. Direct plating to CHROMagar (BD Diagnostics) was compared to a broth preenrichment followed by plating to Baird-Parker agar. The broth-enrichment method was comparable to CHROMagar for methicillin-resistant Staphylococcus aureas (MRSA) detection, but the enrichment method was optimum for recovery of coagulase-positive Staphylococcus spp.
Patients with community-associated methicillin-resistant Staphylococcus aureus (MRSA) and their household companions often develop recurrent episodes of MRSA infection. Cyclical reinfection within households, potentially driven by environmental or animal reservoirs, contributes to the burden of MRSA infection (1). Culture of specific organisms from the environment typically requires enrichment or other selection methods to address contamination with nontarget bacteria (2, 3). Methods that allow culture of Staphylococcus spp. other than S. aureus are critical to assess cocolonization outcomes and the presence of animalassociated staphylococci, given the potential role for these microbiota to modulate colonization by pathogens (4). Currently, the culture-based screening methods to identify S. aureus from human samples are generally different from methods for environmental or animal samples. Use of the same culture method for all types of samples (human, environmental, animal) would enhance the comparability of results. However, methods designed for environmental and animal specimens may not be optimal for use on human samples. The aim of this study was to compare a method to screen for MRSA and methicillin-susceptible S. aureus (MSSA) using CHROMagar media (5) with a broth-enrichment method, used on the same specimens, that was optimized to detect methicillin-susceptible and methicillin-resistant staphylococci from environmental and animal specimens (2, 6).(Portions of this work were presented at the Consortium of Universities for Global Health conference [7] and the 2015 ASM-ESCMID Conference on Methicillin-Resistant Staphylococci in Animals.)Index participants with MRSA skin or soft tissue infection (SSTI) and their household members were recruited as part of a three-arm nonblinded, randomized, controlled trial (NCT00966446), i.e., the Commonwealth Universal Research Enhancement (CURE) trial (8). This trial evaluated the effect of two similar householdwide decolonization protocols using nasal mupirocin ointment and chlorhexidine body wash versus education control on human MRSA colonization. A subset of these households participated in a nested evaluation of home environments and companion animals, i.e., the Pets and Environmental Transmission of Staphylococci (PETS) study (6, 9). Two home visits were conducted at a 3-month interval; randomization and treatment occurred between these visits. People sampled themselves using Copan ESwabs (Copan Diagnostics, Murrieta, CA) at (i) both nares and (ii) axillae and groin creases (pooled, referred to as the skin site). Index patients submitted a third E...