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Staphylococcus aureus nasal carriage among homeless population in Lisbon, Portugal

  • Teresa ConceiçãoEmail author
  • Hugo Martins
  • Suzilaine Rodrigues
  • Hermínia de Lencastre
  • Marta Aires-de-Sousa
Original Article

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage is a major risk factor for infection, namely among populations in the community with inherent prompting factors, such as the homeless. In Portugal, there are no data on S. aureus/MRSA nasal carriage among the homeless community. A total of 84 homeless individuals living in Lisbon (34 with no permanent address and 50 living in shelter) were nasally screened for S. aureus/ MRSA. All isolates were characterized to determine antimicrobial susceptibility and clonal type. A total of 43 (51.2%) S. aureus carriers were identified, including a single individual colonized with MRSA (1.2%). S. aureus carriage rate was higher among individuals with no permanent address (58.8% versus 46%), younger (45.7 ± 12.7 versus 52.5 ± 10.8 years), and with diagnosis of asthma (9% versus 0%). The single MRSA belonged to the EMRSA-15 clone (PFGE D, ST15-SCCmec IVh, and spa type t790). Almost half of the methicillin-susceptible S. aureus (MSSA) isolates (41.9%, n = 18) belonged to two major clones, ST398-t1451 (n = 13) and ST30-t399/t11980/t12808 associated with PFGE I (n = 5). A high proportion of isolates showed non-susceptibility to mupirocin (64%), erythromycin (45%), and fusidic acid (20%) and induced resistance to clindamycin (39%). None of the isolates harboured PVL. Our results suggest that the homeless population of Lisbon does not constitute a reservoir of MRSA in the community, but harbour the highly transmissible ST398-t1451 MSSA lineage.

Keywords

MRSA Nasal carriage Homeless Portugal 

Notes

Acknowledgements

The authors are grateful to the medical doctors and nurses of the VOXLisboa association for the given assistance during the nasal screenings.

Funding

This work was partly supported by project PTDC/DTP-EPI/0842/2014 from Fundação para a Ciência e a Tecnologia (FCT), Portugal, by Project LISBOA-01-0145-FEDER-007660 (Microbiologia Molecular, Estrutural e Celular) funded by FEDER funds through COMPETE2020-Programa Operacional Competitividade e Internacionalização (POCI) and by national funds through FCT, and by ONEIDA project LISBOA-01-0145-FEDER-016417 co-funded by FEEI-“Fundos Europeus Estruturais e de Investimento” from “Programa Operacional Regional Lisboa 2020” and by national funds from FCT. Teresa Conceição and Suzilaine Rodrigues were supported by grants SFRH/BPD/72422/2010 and 02/BI/2017 respectively, from FCT, Portugal.

Compliance with ethical standards

The protocol was approved by the Ethics Committee of Escola Superior de Saúde da Cruz Vermelha Portuguesa and a written informed consent was obtained from all participants.

Conflict of interest

The authors declare that they have no competing interests.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Teresa Conceição
    • 1
    Email author
  • Hugo Martins
    • 2
    • 3
    • 4
  • Suzilaine Rodrigues
    • 1
  • Hermínia de Lencastre
    • 1
    • 5
  • Marta Aires-de-Sousa
    • 1
    • 6
  1. 1.Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica António Xavier (ITQB-NOVA)Universidade Nova de LisboaOeirasPortugal
  2. 2.Unidade de Atendimento Urgente AdultosHospital Lusíadas LisboaLisbonPortugal
  3. 3.Urgência GeralHospital Prof. Doutor Fernando da FonsecaLisbonPortugal
  4. 4.Departamento Formação, Investigação e PlaneamentoVOXLisboaLisbonPortugal
  5. 5.Laboratory of Microbiology and Infectious DiseasesThe Rockefeller UniversityNew YorkUSA
  6. 6.Escola Superior de Saúde da Cruz Vermelha Portuguesa (ESSCVP)LisbonPortugal

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