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Background    Staphylococcus aureus  can asymptomatically colonize the human anterior nares and skin, and nasal colonization by this bacterium represents a potential risk for development of invasive infections. The aim of this study was to determine the prevalence of  S. aureus  nasal carriage among healthcare workers and students attending a university hospital and to characterize the isolates phenotypically and molecularly.Methods   A cross-sectional study was performed with 324 volunteers. Cultures from nasal samples were obtained and  S. aureus  isolates were characterized according to their antimicrobial susceptibility profile and four virulence factors-encoding genes. MRSA isolates were characterized regarding their oxacillin/cefoxitin susceptibility, SCC mec,  and REP-PCR types. Potential risks for  S. aureus  and MRSA carriage were analyzed.Results   Of 324 nasal samples, 42.9% were identified as  S. aureus , of which 28.8% were MRSA.  S. aureus  carriers were significantly higher in males and students (OR = 2.898, 95%CI 1.553–5.410); however, no variables were associated with MRSA carriage. All isolates were susceptible to vancomycin and the highest rate of resistance was observed for penicillin (90.6%). All isolates harbored the  coa  gene, and 97.8%, the  icaA  gene; 15.8% and 6.5% were positive for  tst  and  lukS-PV/lukF-PV  genes, respectively. Among MRSA isolates, 45% carried the  mecA  gene but were phenotypically susceptible to oxacillin/cefoxitin; two harbored the  tst  and none had  lukS-PV/lukF-PV  genes. All MRSAs were distributed into six SCC mec  types and type I (62.5%) was the most frequent. REP-PCR typing identified four main clusters among MRSA isolates.Conclusion   High prevalence of healthcare workers and students were identified as nasal carriers of  S. aureus  exhibiting different antimicrobial resistance profiles, including  mecA -positive oxacillin-susceptible  S. aureus  (OS-MRSA) and the presence of virulence-encoding genes. Both cohorts may represent potential sources for the emergence of a successful  S. aureus  strain highly adapted to the hospital environment.

interdisciplinary perspectives on infectious diseases

Nasal Carriage by Staphylococcus aureus among Healthcare Workers and Students Attending a University Hospital in Southern Brazil: Prevalence, Phenotypic, and Molecular Characteristics