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Staphylococcus aureus nasal colonization among dental health care workers in Northern Germany (StaphDent study)

Lerche, Nadine; Holtfreter, Silva; Walther, Birgit; Semmler, Torsten; Al�Sholui, Fawaz; Dancer, Stephanie J.; Daeschlein, Georg; H�bner, Nils-Olaf; Br�ker, Barbara M.; Papke, Roald; Kohlmann, Thomas; Baguhl, Romy; Seifert, Ulrike; Kramer, Axel

Authors

Nadine Lerche

Silva Holtfreter

Birgit Walther

Torsten Semmler

Fawaz Al�Sholui

Georg Daeschlein

Nils-Olaf H�bner

Barbara M. Br�ker

Roald Papke

Thomas Kohlmann

Romy Baguhl

Ulrike Seifert

Axel Kramer



Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) can colonize dental patients and students, however, studies on the prevalence of MRSA and methicillin-susceptible S. aureus (MSSA) among dental health care workers (DHCW) including use of personal protective equipment (PPE) are scarce. We conducted an observational study (StaphDent study) to (I) determine the prevalence of MRSA and MSSA colonization in DHCW in the region of Mecklenburg Western-Pomerania, Germany, (II) resolve the MSSA population structure to gain hints on possible transmission events between co-workers, and (III) clarify use of PPE. Nasal swabs were obtained from dentists (n = 149), dental assistants (n = 297) and other dental practice staff (n = 38). Clonal relatedness of MSSA isolates was investigated using spa typing and, in some cases, whole genome sequencing (WGS). PPE use was assessed by questionnaire. While 22.3% (108/485) of the participants were colonized with MSSA, MRSA was not detected. MSSA prevalence was not associated with size of dental practices, gender, age, or duration of employment. The identified 61 spa types grouped into 17 clonal complexes and four sequence types. Most spa types (n = 51) were identified only once. In ten dental practices one spa type occurred twice. WGS data analysis confirmed a close clonal relationship for 4/10 isolate pairs. PPE was regularly used by most dentists and assistants. To conclude, the failure to recover MRSA from DHCW reflects the low MRSA prevalence in this region. Widespread PPE use suggests adherence to routine hygiene protocols. Compared to other regional HCW MRSA rates the consequent usage of PPE seems to be protective.

Citation

Lerche, N., Holtfreter, S., Walther, B., Semmler, T., Al’Sholui, F., Dancer, S. J., Daeschlein, G., Hübner, N.-O., Bröker, B. M., Papke, R., Kohlmann, T., Baguhl, R., Seifert, U., & Kramer, A. (2021). Staphylococcus aureus nasal colonization among dental health care workers in Northern Germany (StaphDent study). International Journal of Medical Microbiology, 311(6), Article 151524. https://doi.org/10.1016/j.ijmm.2021.151524

Journal Article Type Article
Acceptance Date Jul 16, 2021
Online Publication Date Jul 17, 2021
Publication Date 2021-08
Deposit Date Aug 2, 2021
Publicly Available Date Jul 18, 2022
Journal International Journal of Medical Microbiology
Print ISSN 1438-4221
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 311
Issue 6
Article Number 151524
DOI https://doi.org/10.1016/j.ijmm.2021.151524
Keywords Staphylococcus aureus, MRSA, dental practices, dentist, spa typing, epidemiology
Public URL http://researchrepository.napier.ac.uk/Output/2788789

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Publisher Licence URL
http://creativecommons.org/licenses/by-nc-nd/4.0/

Copyright Statement
Licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license.





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