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Background  Residents in nursing homes (NHs) always represent potential reservoirs for  Staphylococcus aureus  and methicillin-resistant  S .  aureus  (MRSA). To our knowledge, there is no epidemiological information up till now that describes the prevalence and molecular characteristics of  S .  aureus  in nursing home residents in Shanghai, China.    Methods  Four hundred and ninety-one unique residents from 7 NHs were enrolled in this study. Specimens were collected among these residents including 491 nasal swabs, 487 axillary swabs and 119 skin swabs.  S .  aureus  isolated and identified from the swabs was characterized according to antimicrobial susceptibility profiling, toxin gene prevalence, and multilocus sequence typing (MLST),  spa  and SCC mec  typing.    Results  Among the 491 residents screened,  S .  aureus  was isolated in 109 residents from 90 nasal swabs (90/491, 18.3%), 29 axillary swabs (29/487, 6.0%), and 22 skin swabs (22/119, 18.5%). Sixty-eight MRSA isolates were detected in 52 residents from 41 nasal carriers, 15 axillary carriers and 12 skin carriers. The overall prevalence rate of  S .  aureus  and MRSA colonization was 22.2% and 10.6% respectively. Ten residents presented  S .  aureus  in all three sample types and 12 residents presented  S .  aureus  in two of the three sample types collected. Molecular analysis revealed CC1 (29.1%) to be the dominant clone in this study, followed by CC398 (19.9%), CC188 (13.5%) and CC5 (12.8%). The most common  spa  type was t127 (22.0%), followed by t14383 (12.8%) and t002 (10.6%).    Conclusions  A high prevalence of  S .  aureus  and MRSA colonization was revealed in nursing home residents in Shanghai. CC1 was the most common clonal complex and t127 was the most common  spa  type among NH residents. The data provides an important baseline for future surveillance of  S .  aureus  in NHs in Shanghai and other highly urbanized regions in China. Implementation of infection control strategies must be given high priority in NHs to fight such high prevalence of both MRSA and methicillin-susceptible  S .  aureus  (MSSA).

Prevalence and Molecular Epidemiology of Staphylococcus aureus among Residents of Seven Nursing Homes in Shanghai