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      Contamination of Public Buses with MRSA in Lisbon, Portugal: A Possible Transmission Route of Major MRSA Clones within the Community

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          In a previous study we have shown that public buses in Oporto, the second largest city in Portugal, were highly contaminated with MRSA. Here we describe the results of a similar study performed in another urban area of Portugal–Lisbon, the capital. Between May 2011 and May 2012, hand touched surfaces of 199 public buses in Lisbon were screened for MRSA contamination. Subsequently, the hands of 575 passengers who frequently use these bus lines were also screened. All hand carriers of MRSA were further screened for nasal carriage. The isolates were characterized by PFGE, staphylococcal cassette chromosome (SCC) mec typing, spa typing, MLST and were tested for the presence of mecA, Panton-Valentine leukocidin and arginine catabolic mobile element genes. MRSA contamination was shown in 72 buses (36.2%). The majority of the isolates belonged to three major clones: Clone A was identified as EMRSA-15 defined by pattern PFGE A, spa types t2357/t747/t025/t379/t910, ST22, and SCC mec IVh (n = 21; 29%). Clone B was the New York/Japan clone characterized by PFGE B-t002/t10682-ST5-II (n = 15; 21%). Clone C included isolates with characteristics of the international community-acquired USA300 or related clones, PFGE C-t008-ST8-IVa/IVc/IVg/IVnt/VI (n = 19; 26%). The first two clones are currently the two major lineages circulating in Portuguese hospitals. The hands of 15 individuals were contaminated with MRSA belonging to the nosocomial clones A or B. Eleven of these individuals were not nasal carriers of MRSA and all but one had travelled by public transportation, namely by bus, prior to sampling. In conclusion, public buses in two major cities in Portugal are often contaminated with MRSA representing clones dominant in hospitals in the particular geographic area. MRSA contamination of public transport and the transfer of the bacteria to the hands of passengers may represent a route through which hospital-acquired MRSA clones may spread to the community.

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          Author and article information

          Role: Editor
          PLoS One
          PLoS ONE
          PLoS ONE
          Public Library of Science (San Francisco, USA )
          6 November 2013
          : 8
          : 11
          [1 ]Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica (ITQB), Universidade Nova de Lisboa (UNL), Oeiras, Portugal
          [2 ]Faculdade de Ciências e Centro de Estatística e Aplicações, Universidade de Lisboa (FCUL e CEAUL), Lisboa, Portugal
          [3 ]Laboratory of Microbiology, The Rockefeller University, New York, New York, United States of America
          [4 ]Escola Superior de Saúde da Cruz Vermelha Portuguesa (ESSCVP), Lisboa, Portugal
          Columbia University, United States of America
          Author notes

          Competing Interests: Co-author Herminia de Lencastre is a PLOS ONE Editorial Board member. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

          Conceived and designed the experiments: MAS HdL. Performed the experiments: TC CC. Analyzed the data: TC MAS FD HdL. Wrote the paper: MAS.


          This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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          Pages: 6
          This work was partially supported by project PTDC/SAU-SAP/118813/2010 and grants No. PEst-OE/EQB/LA0004/2011 and PEst-OE/MAT/UI0006/2011 from Fundação para a Ciência e a Tecnologia (FCT), Portugal. T. Conceição was supported by grant SFRH/BPD/72422/2010. C. Coelho was supported by grant 036/BI-BI/2012 from FCT, Portugal. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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