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Risk of Staphylococcus aureus carriage in childcare employees.

ABSTRACT: Asymptomatic carriage of Staphylococcus aureus is an important risk factor for developing infection, as well as a key contributor to transmission. Despite the fact that childcare workers are at known risk for infections, little research has focused on bacterial carriage in this occupational group. We conducted a cross-sectional study comparing the prevalence of S. aureus in 110 childcare employees with the prevalence in 111 unexposed participants. Questionnaire data was collected for employees, unexposed adults, and children. Multivariate analysis allowed for adjustment for confounders. Data on work-related exposures are presented as well. The prevalence of S. aureus in employees, unexposed adults, children, and on surfaces was 35·2%, 33·6%, 19·8%, and 9·8%, respectively. Washing children's hands upon their arrival at childcare facilities may decrease the risk of S. aureus carriage in employees (odds ratio 0·17, 95% confidence interval 0·095–0·32, P < 0·0001).

SUBMITTER: Moritz ED

PROVIDER: S-EPMC9155284 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature

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Risk of Staphylococcus aureus carriage in childcare employees.

Moritz E D ED Smith T C TC

Epidemiology and infection 20121123 9

Asymptomatic carriage of Staphylococcus aureus is an important risk factor for developing infection, as well as a key contributor to transmission. Despite the fact that childcare workers are at known risk for infections, little research has focused on bacterial carriage in this occupational group. We conducted a cross-sectional study comparing the prevalence of S. aureus in 110 childcare employees with the prevalence in 111 unexposed participants. Questionnaire data was collected for employees, ...[more]

PMID: 23176789

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Project description:BackgroundStaphylococcus aureus is a major cause of healthcare associated mortality, but like many important bacterial pathogens, it is a common constituent of the normal human body flora. Around a third of healthy adults are carriers. Recent evidence suggests that evolution of S. aureus during nasal carriage may be associated with progression to invasive disease. However, a more detailed understanding of within-host evolution under natural conditions is required to appreciate the evolutionary and mechanistic reasons why commensal bacteria such as S. aureus cause disease. Therefore we examined in detail the evolutionary dynamics of normal, asymptomatic carriage. Sequencing a total of 131 genomes across 13 singly colonized hosts using the Illumina platform, we investigated diversity, selection, population dynamics and transmission during the short-term evolution of S. aureus.Principal findingsWe characterized the processes by which the raw material for evolution is generated: micro-mutation (point mutation and small insertions/deletions), macro-mutation (large insertions/deletions) and the loss or acquisition of mobile elements (plasmids and bacteriophages). Through an analysis of synonymous, non-synonymous and intergenic mutations we discovered a fitness landscape dominated by purifying selection, with rare examples of adaptive change in genes encoding surface-anchored proteins and an enterotoxin. We found evidence for dramatic, hundred-fold fluctuations in the size of the within-host population over time, which we related to the cycle of colonization and clearance. Using a newly-developed population genetics approach to detect recent transmission among hosts, we revealed evidence for recent transmission between some of our subjects, including a husband and wife both carrying populations of methicillin-resistant S. aureus (MRSA).SignificanceThis investigation begins to paint a picture of the within-host evolution of an important bacterial pathogen during its prevailing natural state, asymptomatic carriage. These results also have wider significance as a benchmark for future systematic studies of evolution during invasive S. aureus disease.

Dataset Information

Risk of Staphylococcus aureus carriage in childcare employees.

Publications

Risk of Staphylococcus aureus carriage in childcare employees.

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