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Staphylococcus aureus nasal colonization level and intracellular reservoir: a prospective cohort study

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Abstract

Staphylococcus aureus is a major pathogen in humans. The nasal vestibule is considered as the main reservoir of S. aureus. However, even though the nasal cavity may also be colonized by S. aureus, the relationships between the two sites are still unclear. We conducted a prospective study in humans to assess the S. aureus colonization profiles in the vestibule and nasal cavity, and to investigate the presence of intracellular S. aureus in the two sites. Patients undergoing ear, nose, and throat surgery were swabbed during endoscopy to determine S. aureus nasal load, genotype, and presence of intracellular S. aureus. Among per-operative samples from 90 patients, the prevalence of S. aureus carriage was 32.2% and 33.3% in the vestibule and the nasal cavity, respectively. The mean S. aureus load was 4.10 and 4.25 log10 CFU/swab for the nasal vestibule and nasal cavity, respectively (P > 0.05). Genotyping of S. aureus revealed that all nasal strains isolated from a given individual belong to the same clonal complex and spa-type. An intracellular carriage was observed in 5.6% of the patients, all of whom exhibited a S. aureus vestibule load higher than 3 log10 CFU/swab. An intracellular niche was observed in the vestibule as well as in the nasal cavity. In conclusion, the nasal cavity was also found to be a major site of S. aureus carriage in humans and should draw attention when studying host-pathogen interactions related to the risk of infection associated with colonization.

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Data used in the manuscript are available upon request to the corresponding author.

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Acknowledgements

We thank Zhiguo He for his help in acquiring confocal microscopy images. Amélie Prier is acknowledged for her technical assistance. The ENT department staff and the bacteriology lab technicians are thanked for their contributions to the study.

Funding

This work was promoted and supported by a grant (no. 1508154 and 1608043) of the University Hospital of St-Etienne.

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Authors and Affiliations

Authors

Contributions

POV, FG, FL, PB, and BP designed the study. Screening swabs were performed by JR, YL, and nurses of the ENT department. MG, YL, and JMP enrolled patients and performed sampling procedures during surgery. JR, MFM, and AC performed the microbiological procedures. JR and AC performed the immunolabeling for confocal microscopy. FG analyzed spa-typing and microarray data. FL supervised the generation of data from the microarray. JR, POV, MF, and EBN analyzed data. JR, POV, MF, and EBN wrote the manuscript. POV, FG, EBN, PB, and BP obtained funding for the study and supervised the project.

Corresponding author

Correspondence to Paul O. Verhoeven.

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This study was approved by an Institutional Review Board and by the National Security Agency of Medicine and Health Products (NCT02595112). An informed consent form was signed and obtained by all participants.

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Rigaill, J., Gavid, M., Fayolle, M. et al. Staphylococcus aureus nasal colonization level and intracellular reservoir: a prospective cohort study. Eur J Clin Microbiol Infect Dis 42, 621–629 (2023). https://doi.org/10.1007/s10096-023-04591-z

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  • DOI: https://doi.org/10.1007/s10096-023-04591-z

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