JCM Accepts, published online ahead of print on 4 November 2009

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J. Clin. Microbiol. doi:10.1128/JCM.01572-09
Copyright (c) 2009, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Nasal colonization and clonal transmission of methicillin-susceptible Staphylococcus aureus in Chinese military volunteers

Fen Qu, Enbo Cui, Tongsheng Guo, Haijing Li, Suming Chen, Liming Liu, Wang Han, Chunmei Bao, Yuanli Mao, and Yi-Wei Tang^*

Clinical Diagnostic Center, 302nd Hospital of the People's Liberation Army, Beijing 100039, China; Departments of Pathology and Medicine, Vanderbilt University Medical Center, Nashville, TN 37232

^* To whom correspondence should be addressed. Email: yiwei.tang{at}vanderbilt.edu.

Military facilities provide unique opportunities for studying Staphylococcus aureus nasal colonization and transmission patterns. In this cross-sectional observational study, we assessed the prevalence of S. aureus nasal colonization among Chinese military volunteers in two camps in the Beijing area. Antimicrobial resistance patterns, risk factors for colonization and transmission patterns using pulsed-field gel electrophoresis were also evaluated. From May to July 2007, 1,044 nasal swabs were collected from military volunteers from suburban (560) and urban (484) camps. A total of 209 S. aureus isolates were recovered of which all methicillin susceptible. Independent factors associated with methicillin-susceptible S. aureus (MSSA) nasal colonization included younger age (OR=1.51, 95% CI=1.03-2.21, P=0.0347), higher education (OR=1.38, 95% CI=1.10-1.73, P=0.0056), shorter length of service (OR=1.74, 95% CI=1.28-2.36, P=0.0004), non-smoking (OR=1.61, 95% CI=1.14-2.28, P=0.0069), and inactive participation of social events (OR=2.40, 95% CI=1.25-5.49, P=0.0082). Among 209 MSSA isolates, 126 (60.3%) were determined to be epidemic and a total of 12 genotypeswere identified of which four (90, 71.4%) represented the majority of strains. Length of service and camp location were statistically related to the four major MSSA genotype clonal transmissions. Our data indicated that MSSA, not MRSA, nasal colonization and clonal transmission occur in healthy military volunteers in Beijing. Younger, female, non-smoking, volunteers with higher education and inactive no active participation of social events of social events who served shorter are at higher risk for nasal MSSA carriage.