Discovery of infectious disease risk factors - MRSA prevalence study

The Gram-positive opportunistic pathogen Staphylococcus aureus (S. aureus) is a frequent member of the human nasal microbiota. Although often asymptomatic,   prolonged phases of nasal carriage of S. aureus can lead to autogenous infections that can be passed on to other individuals to cause different types of infections.

In the past epidemiological studies investigated impact on carriage and transmission of methicillin-resistant Staphylococcus aureus (MRSA) on hospital and health-service settings. In order to improve the availability of data regarding community settings, like households, we performed studies on the epidemiology of S. aureus carriage patterns in households over time to shed light on potential risk factors for colonization to recommend strategies to prevent future infections.

First, we conducted a feasibility study to investigate the applicability of self-guided sampling with nasal swabs at the participant’s households. Here, we concluded that self-swabbing of the nasal cavity at home is a cost-effective and reasonable practicable method for prospective large-scale population studies in the field of infectious epidemiology.

Based on the feasibility study we conducted a randomized community-based study on S. aureus nasal colonization in a non-hospitalized population of Northern Germany. Therefore we analyzed the propagation of antibiotic resistant pathogen Methicillin resistant MRSA in a Brunswick based study (s-swab study) in which people were asked to send in monthly nasal swabs. The swabs were subsequently analysed for bacterial growth on culture plates with and without certain antibiotics. Besides the observation that our results reflected previous findings regarding risk factors for S. aureus carriage and that MRSA-carriage was relatively uncommon, we were able to reveal the occurrence of hospital-associated MRSA spa types in the community setting.

Based on strains that were obtained during the above mentioned epidemiological studies a follow-up study conducted by U. Nübel at the DSMZ uses genome sequencing (CSI Phylogeny-based SNP analysis, and whole-genome multilocus sequence typing) from 214 S. aureus isolates from families for characterization of the molecular evolution of S. aureus strains with in households. 


Cuny C, Arnold P, Hermes J, Eckmanns T, Mehraj J, Schoenfelder S, Ziebuhr W, Zhao Q, Wang Y, Fessler AT, Krause G, et al. Occurrence of cfr-mediated multiresistance in staphylococci from veal calves and pigs, from humans at the corresponding farms, and from veterinarians and their family members. Vet Microbiol. 2017;200:88-94.

Mehraj J, Witte W, Akmatov MK, Layer F, Werner G, Krause G. Epidemiology of Staphylococcus aureus Nasal Carriage Patterns in the Community. Curr Top Microbiol Immunol. 2016;398:55-87.

Mehraj J, Akmatov MK, Strompl J, Gatzemeier A, Layer F, Werner G, Pieper DH, Medina E, Witte W, Pessler F, Krause G. Methicillin-sensitive and methicillin-resistant Staphylococcus aureus nasal carriage in a random sample of non-hospitalized adult population in northern Germany. PloS one. 2014;9(9):e107937.

Akmatov MK, Mehraj J, Gatzemeier A, Strömpl J, Witte W, Krause G, Pessler F. Serial home-based self-collection of anterior nasal swabs to detect Staphylococcus aureus carriage in a randomized population-based study in Germany. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2014;25:4-10.


  • Robert Koch Institute, Wernigerode, Germany
  • Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures, DZIF Group Microbial Genome Research


Beteiligte Gruppen

Geldgeber / Förderer

HZI - Helmholtz-Zentrum für Infektionsforschung

DruckenPer Mail versendenTeilen