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Open Access Research article

Staphylococcus aureus colonization of healthy military service members in the United States and Afghanistan

Todd J Vento12, Tatjana P Calvano1, David W Cole3, Katrin Mende12, Elizabeth A Rini1, Charla C Tully1, Michael L Landrum12, Wendy Zera12, Charles H Guymon4, Xin Yu1, Miriam L Beckius1, Kristelle A Cheatle1 and Clinton K Murray12*

Author Affiliations

1 Brooke Army Medical Center/San Antonio Military Medical Center, Fort Sam Houston, 3551 Roger Brooke Drive, Fort Sam Houston, Texas 78234, TX, USA

2 Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

3 Blanch field Army Community Hospital, Fort Campbell, KY, USA

4 United States Army Institute of Surgical Research, Fort Sam Houston, TX, USA

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BMC Infectious Diseases 2013, 13:325  doi:10.1186/1471-2334-13-325

Published: 16 July 2013

Abstract

Background

Staphylococcus aureus [methicillin-resistant and methicillin-susceptible (MRSA/MSSA)] is a leading cause of infections in military personnel, but there are limited data regarding baseline colonization of individuals while deployed. We conducted a pilot study to screen non-deployed and deployed healthy military service members for MRSA/MSSA colonization at various anatomic sites and assessed isolates for molecular differences.

Methods

Colonization point-prevalence of 101 military personnel in the US and 100 in Afghanistan was determined by swabbing 7 anatomic sites. US-based individuals had received no antibiotics within 30 days, and Afghanistan-deployed personnel were taking doxycycline for malaria prophylaxis. Isolates underwent identification and testing for antimicrobial resistance, virulence factors, and pulsed-field type (PFT).

Results

4 individuals in the US (4 isolates- 3 oropharynx, 1 perirectal) and 4 in Afghanistan (6 isolates- 2 oropharynx, 2 nare, 1 hand, 1 foot) were colonized with MRSA. Among US-based personnel, 3 had USA300 (1 PVL+) and 1 USA700. Among Afghanistan-based personnel, 1 had USA300 (PVL+), 1 USA800 and 2 USA1000. MSSA was present in 40 (71 isolates-25 oropharynx, 15 nare) of the US-based and 32 (65 isolates- 16 oropharynx, 24 nare) of the Afghanistan-based individuals. 56 (79%) US and 41(63%) Afghanistan-based individuals had MSSA isolates recovered from extra-nare sites. The most common MSSA PFTs were USA200 (9 isolates) in the US and USA800 (7 isolates) in Afghanistan. MRSA/MSSA isolates were susceptible to doxycycline in all but 3 personnel (1 US, 2 Afghanistan; all were MSSA isolates that carried tetM).

Conclusion

MRSA and MSSA colonization of military personnel was not associated with deployment status or doxycycline exposure. Higher S. aureus oropharynx colonization rates were observed and may warrant changes in decolonization practices.

Keywords:
Deployment; Malaria chemoprophylaxis; Doxycycline; Military; Staphylococcus aureus; Colonization