{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T12:36:30Z","timestamp":1793709390297,"version":"4.6.1"},"reference-count":62,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T00:00:00Z","timestamp":1793664000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T00:00:00Z","timestamp":1793664000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"The Startup research funding for talents introduced under Sun Yat-sen University\u2019s \u2018Hundred Talents Program\u2019","award":["00302592031"],"award-info":[{"award-number":["00302592031"]}]},{"name":"The Science and Technology Program of Guangzhou","award":["2023A04J0435"],"award-info":[{"award-number":["2023A04J0435"]}]},{"DOI":"10.13039\/501100001809","name":"The National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270873"],"award-info":[{"award-number":["82270873"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Shenzhen Medical Research Fund","award":["A2403069"],"award-info":[{"award-number":["A2403069"]}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["GZB20250366"],"award-info":[{"award-number":["GZB20250366"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shenzhen Science and Technology Program","award":["JCYJ20250604143659001"],"award-info":[{"award-number":["JCYJ20250604143659001"]}]},{"name":"The Funding of Shenzhen Clinical Research Center for Gastroenterology","award":["LCYSSQ20220823091203008"],"award-info":[{"award-number":["LCYSSQ20220823091203008"]}]},{"name":"The Research Start-up Fund of Post-doctoral of SAHSYSU","award":["ZSQYRSFPD0103"],"award-info":[{"award-number":["ZSQYRSFPD0103"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Intestinal\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      colonization in type 2 diabetes mellitus (T2DM) remains poorly defined with respect to prevalence, clinical associations, and molecular characteristics. We investigated intestinal\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      colonization in 142 patients with T2DM and characterized the recovered isolates using antimicrobial susceptibility testing, resistance gene profiling, multilocus sequence typing, accessory gene regulator typing,\n                      <jats:italic toggle=\"yes\">spa<\/jats:italic>\n                      typing, and whole-genome sequencing. Clinical and laboratory characteristics were compared between colonized and non-colonized patients, and siderophore production and biofilm formation were evaluated in major molecular types.\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      colonization was identified in 30 patients (21.1%, 95% confidence interval: 15.2%\u201328.6%) based on a single fecal sample per patient, including one methicillin-resistant isolate. Isolates remained highly susceptible to most tested antimicrobials, except penicillin. The \u03b2-lactamase gene\n                      <jats:italic toggle=\"yes\">blaZ<\/jats:italic>\n                      was the most prevalent resistance determinant (83.3%). MLST revealed a polyclonal population dominated by ST15 (30.0%), ST1156 (26.7%), and ST5 (26.7%), with agr II (56.7%) and\n                      <jats:italic toggle=\"yes\">spa<\/jats:italic>\n                      type t84 (43.3%) being the most common types. Whole-genome sequencing further demonstrated distinct plasmid architectures between methicillin-susceptible\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      and methicillin-resistant\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      (MRSA) isolates and identified an SCCmec IVc (2B) element in the MRSA isolate. Siderophore production was significantly higher in ST15 and ST1156 than in ST5, whereas biofilm formation did not. These findings provide a comprehensive characterization of the clinical and epidemiological profiles of intestinal\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      colonization in patients with T2DM and highlight the need for continued genomic surveillance and mechanistic studies to support infection prevention and therapeutic strategies.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        Intestinal\n                        <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                        colonization in type 2 diabetes mellitus (T2DM) has remained largely uncharacterized despite the well-documented heightened infection risk in this population. Here, we show that 21.1% (95% confidence interval: 15.2%\u201328.6%) of hospitalized T2DM patients harbor gut\n                        <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                        (only 3.3% methicillin-resistant\n                        <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                        [MRSA]). The isolates form a polyclonal population dominated by ST15, ST1156, and ST5, carry predominantly\n                        <jats:italic toggle=\"yes\">blaZ<\/jats:italic>\n                        , and display lineage-specific differences in siderophore production\u2014an iron-acquisition trait critical for gut persistence. These data establish the diabetic intestine as a clinically relevant reservoir, underscore the limitations of nares-only surveillance, and highlight the need for integrated genomic and mechanistic studies to guide infection prevention in T2DM.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.01789-26","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:02:05Z","timestamp":1790341325000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and molecular epidemiology of type 2 diabetes mellitus-associated intestinal\n                    <i>Staphylococcus aureus<\/i>\n                    colonization"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3618-8693","authenticated-orcid":true,"given":"Lijun","family":"Shen","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0064kty71","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Endocrinology, The Seventh Affiliated Hospital Sun Yat-sen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunxing","family":"He","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0064kty71","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Gastroenterology, Guangdong Provincial Key Laboratory of Digestive Cancer Research, Digestive Diseases Center, Scientific Research Center, The Seventh Affiliated Hospital Sun Yat-sen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Wang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0064kty71","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital Sun Yat-sen University","place":["Shenzhen, China"]},{"name":"Chinese Health Risk Management Collaboration (CHRIMAC)","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Zhang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0064kty71","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Endocrinology, The Seventh Affiliated Hospital Sun Yat-sen University","place":["Shenzhen, 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