E Jauneikaite1, T Ferguson2, M Mosavie3, J L Fallowfield4, T Davey4, N Thorpe4, A Allsopp4, A M Shaw4, D Fudge5, M K O'Shea6, D Wilson5, M Morgan7, B Pichon8, A M Kearns8, S Sriskandan3, L E Lamb9. 1. Department of Medicine, Imperial College London, London, UK; NIHR Health Protection Research Unit in Antimicrobial Resistance and Healthcare-associated Infections, Imperial College London, London, UK; Department of Infectious Disease Epidemiology, Imperial College London, London, UK. 2. Department of Medicine, Imperial College London, London, UK. 3. Department of Medicine, Imperial College London, London, UK; NIHR Health Protection Research Unit in Antimicrobial Resistance and Healthcare-associated Infections, Imperial College London, London, UK. 4. Institute of Naval Medicine, Alverstoke, UK. 5. Academic Department of Military Medicine, Royal Centre for Defence Medicine (Research and Academia), Birmingham, UK. 6. Academic Department of Military Medicine, Royal Centre for Defence Medicine (Research and Academia), Birmingham, UK; Institute of Microbiology and Infection, The University of Birmingham, Birmingham, UK. 7. Department of Microbiology, Royal Devon and Exeter Hospital, Exeter, UK. 8. Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK. 9. Department of Medicine, Imperial College London, London, UK; Academic Department of Military Medicine, Royal Centre for Defence Medicine (Research and Academia), Birmingham, UK; Royal Free London NHS Foundation Trust, London, UK. Electronic address: lucylamb@nhs.net.
Abstract
OBJECTIVES: Skin and soft tissue infections (SSTIs) are a serious health issue for military personnel. Of particular importance are those caused by methicillin-resistant Staphylococcus aureus and Panton-Valentine leucocidin (PVL)-positive S. aureus (PVL-SA), as they have been associated with outbreaks of SSTIs. A prospective observational study was conducted in Royal Marine (RM) recruits to investigate the prevalence of PVL-SA carriage and any association with SSTIs. METHODS: A total of 1012 RM recruits were followed through a 32-week training programme, with nose and throat swabs obtained at weeks 1, 6, 15 and 32. S. aureus isolates were characterized by antibiotic susceptibility testing, spa typing, presence of mecA/C and PVL genes. Retrospective review of the clinical notes for SSTI acquisition was conducted. RESULTS: S. aureus colonization decreased from Week 1 to Week 32 (41% to 26%, p < 0.0001). Of 1168 S. aureus isolates, three out of 1168 (0.3%) were MRSA and ten out of 1168 (0.9%) PVL-positive (all MSSA) and 169 out of 1168 (14.5%) were resistant to clindamycin. Isolates showed genetic diversity with 238 different spa types associated with 25 multi-locus sequence type (MLST) clonal complexes. SSTIs were seen in 35% (351/989) of recruits with 3 training days lost per recruit. SSTI acquisition rate was reduced amongst persistent carriers (p < 0.0283). CONCLUSIONS: Nose and throat carriage of MRSA and PVL-SA was low among recruits, despite a high incidence of SSTIs being reported, particularly cellulitis. Carriage strains were predominantly MSSA with a marked diversity of genotypes. Persistent nose and/or throat carriage was not associated with SSTI acquisition. Putative person-to-person transmission within troops was identified based on spa typing requiring further research to confirm and explore potential transmission routes.
OBJECTIVES: Skin and soft tissue infections (SSTIs) are a serious health issue for military personnel. Of particular importance are those caused by methicillin-resistant Staphylococcus aureus and Panton-Valentine leucocidin (PVL)-positive S. aureus (PVL-SA), as they have been associated with outbreaks of SSTIs. A prospective observational study was conducted in Royal Marine (RM) recruits to investigate the prevalence of PVL-SA carriage and any association with SSTIs. METHODS: A total of 1012 RM recruits were followed through a 32-week training programme, with nose and throat swabs obtained at weeks 1, 6, 15 and 32. S. aureus isolates were characterized by antibiotic susceptibility testing, spa typing, presence of mecA/C and PVL genes. Retrospective review of the clinical notes for SSTI acquisition was conducted. RESULTS: S. aureus colonization decreased from Week 1 to Week 32 (41% to 26%, p < 0.0001). Of 1168 S. aureus isolates, three out of 1168 (0.3%) were MRSA and ten out of 1168 (0.9%) PVL-positive (all MSSA) and 169 out of 1168 (14.5%) were resistant to clindamycin. Isolates showed genetic diversity with 238 different spa types associated with 25 multi-locus sequence type (MLST) clonal complexes. SSTIs were seen in 35% (351/989) of recruits with 3 training days lost per recruit. SSTI acquisition rate was reduced amongst persistent carriers (p < 0.0283). CONCLUSIONS: Nose and throat carriage of MRSA and PVL-SA was low among recruits, despite a high incidence of SSTIs being reported, particularly cellulitis. Carriage strains were predominantly MSSA with a marked diversity of genotypes. Persistent nose and/or throat carriage was not associated with SSTI acquisition. Putative person-to-person transmission within troops was identified based on spa typing requiring further research to confirm and explore potential transmission routes.
Authors: Katherine E Macdonald; Crispin Y Jordan; Emma Crichton; Judith E Barnes; Gillian E Harkin; Lesley M L Hall; Joshua D Jones Journal: BMC Infect Dis Date: 2020-03-12 Impact factor: 3.090
Authors: Gustavo Henrique Rodrigues Vale de Macedo; Gabrielle Damasceno Evangelista Costa; Elane Rodrigues Oliveira; Glauciane Viera Damasceno; Juliana Silva Pereira Mendonça; Lucas Dos Santos Silva; Vitor Lopes Chagas; José Manuel Noguera Bazán; Amanda Silva Dos Santos Aliança; Rita de Cássia Mendonça de Miranda; Adrielle Zagmignan; Andrea de Souza Monteiro; Luís Cláudio Nascimento da Silva Journal: Pathogens Date: 2021-02-02
Authors: Deborah C Holt; Tegan M Harris; Jaquelyne T Hughes; Rachael Lilliebridge; David Croker; Sian Graham; Heather Hall; Judith Wilson; Steven Y C Tong; Phillip M Giffard Journal: PLoS One Date: 2021-02-05 Impact factor: 3.240