{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T16:11:47Z","timestamp":1772208707256,"version":"3.50.1"},"reference-count":62,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:00:00Z","timestamp":1672963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008809","name":"The Scientific Research Deanship at the University of Ha\u2019il, Saudi Arabia","doi-asserted-by":"publisher","award":["RG20184"],"award-info":[{"award-number":["RG20184"]}],"id":[{"id":"10.13039\/501100008809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Staphylococcus aureus\u00a0is a major human-associated pathogen that causes a wide range of clinical infections. However, the increased human dynamics and the changing epidemiology of the species have made it imperative to understand the population structure of local ecotypes, their transmission dynamics, and the emergence of new strains. Since the previous methicillin-resistant S. aureus (MRSA) pandemic, there has been a steady increase in global healthcare-associated infections involving cutaneous and soft tissue and resulting in high morbidities and mortalities. Limited data and paucity of high-quality evidence exist for many key clinical questions about the pattern of S. aureus infections. Using clinical, molecular, and epidemiological characterizations of isolates, hospital data on age and infection sites, as well as antibiograms, we have investigated profiles of circulating S. aureus types and infection patterns. We showed that age-specific profiling in both intensive care unit (ICU) and non-ICU revealed highest infection rates (94.7%) in senior-patients &gt; 50 years; most of which were MRSA (81.99%). However, specific distributions of geriatric MRSA and MSSA rates were 46.5% and 4.6% in ICU and 35.48% and 8.065% in non-ICU, respectively. Intriguingly, the age groups 0\u201320 years showed uniquely similar MRSA patterns in ICU and non-ICU patients (13.9% and 9.7%, respectively) and MSSA in ICU (11.6%). The similar frequencies of both lineages in youth at both settings is consistent with their increased socializations and gathering strongly implying carriage and potential evolutionary replacement of MSSA by MRSA. However, in age groups 20\u201350 years, MRSA was two-fold higher in non-ICU (35%) than ICU (18.6%). Interestingly, a highly significant association was found between infection-site and age-groups (p-value 0.000). Skin infections remained higher in all ages; pediatrics 32.14%, adults 56%, and seniors 25% while respiratory infections were lower in pediatrics (14.3%) and adults (17%) while it was highest in seniors (38%). Blood and \u201cother\u201d sites in pediatrics were recorded (28.6%; 25%, respectively), and were slightly lower in adults (18.6%; 8.6%) and seniors (14%; 22.8%), respectively. Furthermore, a significant association existed between infection-site and MRSA (Chi-Square Test, p-value 0.002). Thus, the common cutaneous infections across all age-groups imply that skin is a significant reservoir for endogenous infections; particularly, for geriatrics MRSA. These findings have important clinical implications and in understanding S. aureus profiles and transmission dynamics across different age groups that is necessary for strategic planning in patient management and infection control.<\/jats:p>","DOI":"10.3390\/microorganisms11010149","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T02:31:30Z","timestamp":1673231490000},"page":"149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Molecular and Source-Specific Profiling of Hospital Staphylococcus aureus Reveal Dominance of Skin Infection and Age-Specific Selections in Pediatrics and Geriatrics"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3749-6754","authenticated-orcid":false,"given":"Kamaleldin B.","family":"Said","sequence":"first","affiliation":[{"name":"Department of Pathology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"},{"name":"Genomics, Bioinformatics and Systems Biology, Carleton University, 1125 Colonel-By Drive, Ottawa, ON K1S 5B6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6783-796X","authenticated-orcid":false,"given":"Naif Saad","family":"Alghasab","sequence":"additional","affiliation":[{"name":"Department of Cardiology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed S. M.","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Alsolami","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2813-6279","authenticated-orcid":false,"given":"Mohd","family":"Saleem","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sulaf A.","family":"Alhallabi","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahad F.","family":"Alafnan","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1594-1826","authenticated-orcid":false,"given":"Azharuddin Sajid Syed","family":"Khaja","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taha E.","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Ha\u2019il COM Research Unit Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bunge, E.M., Hoet, B., Chen, L., Lienert, F., Weidenthaler, H., Baer, L.R., and Steffen, R. (2022). The Changing Epidemiology of Human Monkeypox\u2014A Potential Threat? A Systematic Review. PLoS Negl. Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010141"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1183\/09031936.96.09020386","article-title":"Acute Respiratory Distress Syndrome Due to Methicillin-Resistant Staphylococcus Aureus Sepsis in Hyper-IgE Syndrome","volume":"9","author":"Sato","year":"1996","journal-title":"Eur. Respir. J."},{"key":"ref_3","first-page":"1476","article-title":"Comparison of Community-Acquired Pneumonia Due to Methicillin-Resistant and Methicillin-Susceptible Staphylococcus Aureus Producing the Panton-Valentine Leukocidin","volume":"13","author":"Vardakas","year":"2009","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S344","DOI":"10.1086\/533590","article-title":"Epidemiology of Methicillin-Resistant Staphylococcus Aureus","volume":"46","author":"Boucher","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"868","DOI":"10.3201\/eid1106.040831","article-title":"Methicillin-Resistant\u2013Staphylococcus Aureus Hospitalizations, United States","volume":"11","author":"Kuehnert","year":"2005","journal-title":"Emerg. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1001\/jama.298.15.1763","article-title":"Invasive Methicillin-Resistant Staphylococcus Aureus Infections in the United States","volume":"298","author":"Klevens","year":"2007","journal-title":"JAMA"},{"key":"ref_7","unstructured":"Louise Gerberding, J., Director, M., Cohen, M., Ronald Valdiserri, P.O., Acting Director, M., and Janssen, R.S. (2023, January 01). Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/hiv\/pdf\/library\/reports\/surveillance\/cdc-hiv-surveillance-report-2004-vol-16.pdf."},{"key":"ref_8","unstructured":"(2022, March 19). FastStats-Viral Hepatitis, Available online: https:\/\/www.cdc.gov\/nchs\/fastats\/hepatitis.htm."},{"key":"ref_9","unstructured":"(2022, March 19). Table 1|Reported TB in the US 2020|Data & Statistics|TB|CDC, Available online: https:\/\/www.cdc.gov\/tb\/statistics\/reports\/2020\/table1.htm."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3012","DOI":"10.1001\/jama.293.24.3012","article-title":"Staphylococcus Aureus Endocarditis: A Consequence of Medical Progress","volume":"293","author":"Fowler","year":"2005","journal-title":"JAMA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1001\/jama.298.15.1803","article-title":"Antimicrobial Resistance: It\u2019s Not Just for Hospitals","volume":"298","author":"Bancroft","year":"2007","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1093\/cid\/ciw464","article-title":"Empirical Coverage of Methicillin-Resistant Staphylococcus Aureus in Community-Acquired Pneumonia: Those Who Do Not Remember the Past Are Doomed to Repeat It","volume":"63","author":"Chalmers","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s13054-017-1801-3","article-title":"Incidence, Prevalence, and Management of MRSA Bacteremia across Patient Populations-a Review of Recent Developments in MRSA Management and Treatment","volume":"21","author":"Hassoun","year":"2017","journal-title":"Crit. Care"},{"key":"ref_14","first-page":"19688","article-title":"Methicillin-Resistant Staphylococcus Aureus (MRSA): Burden of Disease and Control Challenges in Europe","volume":"15","author":"Becker","year":"2010","journal-title":"Euro. Surveill."},{"key":"ref_15","first-page":"157","article-title":"WHO Declares COVID-19 a Pandemic","volume":"91","author":"Cucinotta","year":"2020","journal-title":"Acta Bio. Medica. Atenei. Parm."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"571","DOI":"10.3906\/sag-2004-146","article-title":"COVID-19: Prevention and Control Measures in Community","volume":"50","year":"2020","journal-title":"Turk. J. Med. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.ijid.2021.02.087","article-title":"SARS-CoV-2 Respiratory Co-Infections: Incidence of Viral and Bacterial Co-Pathogens","volume":"105","author":"Singh","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1186\/s12879-020-05374-z","article-title":"Evaluation of Bacterial Co-Infections of the Respiratory Tract in COVID-19 Patients Admitted to ICU","volume":"20","author":"Sharifipour","year":"2020","journal-title":"BMC Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1097\/CCM.0b013e3182416f23","article-title":"Critical Illness from 2009 Pandemic Influenza A (H1N1) Virus and Bacterial Co-Infection in the United States","volume":"40","author":"Rice","year":"2012","journal-title":"Crit. Care Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/irv.12089","article-title":"Bacterial and Viral Infections Associated with Influenza","volume":"7","author":"Joseph","year":"2013","journal-title":"Influenza Other Respir Viruses"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.diagmicrobio.2016.08.011","article-title":"Clinical Utility of a Nasal Swab Methicillin-Resistant Staphylococcus Aureus Polymerase Chain Reaction Test in Intensive and Intermediate Care Unit Patients with Pneumonia","volume":"86","author":"Giancola","year":"2016","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jcrc.2016.11.008","article-title":"Clinical Utility of Methicillin-Resistant Staphylococcus Aureus Nasal Polymerase Chain Reaction Assay in Critically Ill Patients with Nosocomial Pneumonia","volume":"38","author":"Smith","year":"2017","journal-title":"J. Crit. Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1097\/CCM.0b013e318243168e","article-title":"Active Surveillance Cultures of Methicillin-Resistant Staphylococcus Aureus as a Tool to Predict Methicillin-Resistant S. Aureus Ventilator-Associated Pneumonia","volume":"40","author":"Chan","year":"2012","journal-title":"Crit. Care Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.ajic.2014.05.026","article-title":"Nasal Screening Is Useful in Excluding Methicillin-Resistant Staphylococcus Aureus in Ventilator-Associated Pneumonia","volume":"42","author":"Langsjoen","year":"2014","journal-title":"Am. J. Infect Control"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1093\/cid\/ciw300","article-title":"Staphylococcus Aureus Community-Acquired Pneumonia: Prevalence, Clinical Characteristics, and Outcomes","volume":"63","author":"Self","year":"2016","journal-title":"Clin. Infect Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1080\/17476348.2019.1562339","article-title":"The Burden of Community-Acquired Bacterial Pneumonia in the Era of Antibiotic Resistance","volume":"13","author":"Peyrani","year":"2019","journal-title":"Expert. Rev. Respir. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"L149","DOI":"10.1152\/ajplung.00100.2021","article-title":"MRSA-Induced Endothelial Permeability and Acute Lung Injury Are Attenuated by FTY720 S-Phosphonate","volume":"322","author":"Wang","year":"2022","journal-title":"Am. J. Physiol. Lung Cell Mol. Physiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.1503\/cmaj.160798","article-title":"Reducing the Global Burden of Sepsis","volume":"189","author":"Dugani","year":"2017","journal-title":"CMAJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/S1473-3099(18)30310-4","article-title":"Estimates of the Global, Regional, and National Morbidity, Mortality, and Aetiologies of Lower Respiratory Infections in 195 Countries, 1990\u20132016: A Systematic Analysis for the Global Burden of Disease Study 2016","volume":"18","author":"Troeger","year":"2018","journal-title":"Lancet Infect Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S0140-6736(14)61682-2","article-title":"Global, Regional, and National Age-Sex Specific All-Cause and Cause-Specific Mortality for 240 Causes of Death, 1990\u20132013: A Systematic Analysis for the Global Burden of Disease Study 2013","volume":"385","author":"Naghavi","year":"2015","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s15010-015-0789-3","article-title":"Clinical and Economic Burden of Community-Acquired Pneumonia in the Veterans Health Administration, 2011: A Retrospective Cohort Study","volume":"43","author":"McLaughlin","year":"2015","journal-title":"Infection"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"E1058","DOI":"10.1503\/cmaj.170149","article-title":"Clinical Implications of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"190","author":"Fernando","year":"2018","journal-title":"CMAJ"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"104","DOI":"10.3389\/fphar.2020.00104","article-title":"Xuebijing Injection Alleviates Pam3CSK4-Induced Inflammatory Response and Protects Mice From Sepsis Caused by Methicillin-Resistant Staphylococcus Aureus","volume":"11","author":"Li","year":"2020","journal-title":"Front. Pharmacol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"214","DOI":"10.15585\/mmwr.mm6809e1","article-title":"Vital Signs: Epidemiology and Recent Trends in Methicillin-Resistant and in Methicillin-Susceptible Staphylococcus Aureus Bloodstream Infections - United States","volume":"68","author":"Kourtis","year":"2019","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1007\/s10096-016-2651-7","article-title":"Community-Associated Staphylococcus Aureus Pneumonia among Greek Children: Epidemiology, Molecular Characteristics, Treatment, and Outcome","volume":"35","author":"Doudoulakakis","year":"2016","journal-title":"Eur. J. Clin. Microbiol. Infect Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.jgar.2018.01.017","article-title":"Emergence of Vancomycin-Intermediate and -Resistant Staphylococcus Aureus among Methicillin-Resistant S. Aureus Isolated from Clinical Specimens in the Northwest of Iran","volume":"14","author":"Ghahremani","year":"2018","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Boswihi, S.S., Udo, E.E., Monecke, S., Mathew, B., Noronha, B., Verghese, T., and Tappa, S.B. (2018). Emerging Variants of Methicillin-Resistant Staphylococcus Aureus Genotypes in Kuwait Hospitals. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0195933"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.nmni.2016.07.009","article-title":"Molecular Characterization of Methicillin-Resistant Staphylococcus Aureus in Nosocomial Infections in a Tertiary-Care Facility: Emergence of New Clonal Complexes in Saudi Arabia","volume":"14","author":"Senok","year":"2016","journal-title":"New Microbes New Infect."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.2147\/IDR.S218870","article-title":"Emergence of Novel Methicillin-Resistant Staphylococcus Aureus Strains in a Tertiary Care Facility in Riyadh, Saudi Arabia","volume":"12","author":"Senok","year":"2019","journal-title":"Infect. Drug Resist."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/j.1574-6976.2007.00086.x","article-title":"Evolution and Pathogenesis of Staphylococcus Aureus: Lessons Learned from Genotyping and Comparative Genomics","volume":"32","author":"Feng","year":"2008","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4584","DOI":"10.1128\/JB.187.13.4584-4591.2005","article-title":"Host-and Tissue-Specific Pathogenic Traits of Staphylococcus Aureus","volume":"187","author":"Melles","year":"2005","journal-title":"J. Bacteriol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1128\/JB.188.1.169-178.2006","article-title":"Evidence for Clonal Evolution among Highly Polymorphic Genes in Methicillin-Resistant Staphylococcus Aureus","volume":"188","author":"Kuhn","year":"2006","journal-title":"J. Bacteriol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3307","DOI":"10.1128\/JB.185.11.3307-3316.2003","article-title":"How Clonal Is Staphylococcus Aureus?","volume":"185","author":"Feil","year":"2003","journal-title":"J. Bacteriol."},{"key":"ref_44","first-page":"3","article-title":"Surveillance of Antimicrobial Resistance among Clinical Isolates Recovered from a Tertiary Care Hospital in Al Qassim, Saudi Arabia","volume":"8","author":"Said","year":"2014","journal-title":"Int. J. Health Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1089\/fpd.2009.0334","article-title":"Organ- and Host-Specific Clonal Groups of Staphylococcus Aureus from Human Infections and Bovine Mastitis Revealed by the Clumping Factor A Gene","volume":"7","author":"Said","year":"2010","journal-title":"Foodborne Pathog. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.diagmicrobio.2008.09.004","article-title":"Repeat-Based Subtyping and Grouping of Staphylococcus Aureus from Human Infections and Bovine Mastitis Using the R-Domain of the Clumping Factor A Gene","volume":"63","author":"Said","year":"2009","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2021050","DOI":"10.4084\/MJHID.2021.050","article-title":"Epidemiology of Methicillin-Resistant Staphylococcus Aureus in Arab Countries of the Middle East and North African (MENA) Region","volume":"13","author":"Tabaja","year":"2021","journal-title":"Mediterr. J. Hematol. Infect. Dis."},{"key":"ref_48","unstructured":"(2022, December 22). Global Laboratory Standards for a Healthier World. Available online: www.clsi.org\/."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-Resistant, Extensively Drug-Resistant and Pandrug-Resistant Bacteria: An International Expert Proposal for Interim Standard Definitions for Acquired Resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1111\/j.1469-0691.2008.02060.x","article-title":"Prevalence of Methicillin-Resistant Staphylococcus Aureus and Factors Associated with Colonization among Residents in Community Long-Term-Care Facilities in Spain","volume":"14","author":"Manzur","year":"2008","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1086\/665711","article-title":"Methicillin-Resistant Staphylococcus Aureus (MRSA) Nasal Carriage in Residents of Veterans Affairs Long-Term Care Facilities: Role of Antimicrobial Exposure and MRSA Acquisition","volume":"33","author":"Stone","year":"2012","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Sasahara, T., Ae, R., Yoshimura, A., Kosami, K., Sasaki, K., Kimura, Y., Akine, D., Ogawa, M., Hamabata, K., and Hatakeyama, S. (2020). Association between Length of Residence and Prevalence of MRSA Colonization among Residents in Geriatric Long-Term Care Facilities. BMC Geriatr., 20.","DOI":"10.1186\/s12877-020-01885-1"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Villodres, \u00c1., Mart\u00edn-Gandul, C., Pe\u00f1alva, G., Guisado-Gil, A.B., Crespo-Rivas, J.C., Pach\u00f3n-Ib\u00e1\u00f1ez, M.E., Lepe, J.A., and Cisneros, J.M. (2021). Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities around the World: A Review. Antibiotics, 10.","DOI":"10.3390\/antibiotics10060680"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1186\/s13054-015-0876-y","article-title":"Impact of Active Screening for Methicillin-Resistant Staphylococcus Aureus (MRSA) and Decolonization on MRSA Infections, Mortality and Medical Cost: A Quasi-Experimental Study in Surgical Intensive Care Unit","volume":"19","author":"Lee","year":"2015","journal-title":"Crit. Care"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2530","DOI":"10.1093\/cid\/ciz720","article-title":"Reductions in Methicillin-Resistant Staphylococcus Aureus, Clostridium Difficile Infection and Intensive Care Unit\u2013Acquired Bloodstream Infection Across the United Kingdom Following Implementation of a National Infection Control Campaign","volume":"70","author":"Edgeworth","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1093\/cid\/cix1056","article-title":"Regional Epidemiology of Methicillin-Resistant Staphylococcus Aureus Among Adult Intensive Care Unit Patients Following State-Mandated Active Surveillance","volume":"66","author":"Lin","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"3698","DOI":"10.1177\/0300060518777812","article-title":"Methicillin-Resistant Staphylococcus Aureus Nasal and Infection in an Intensive Care Unit of a University Hospital In","volume":"46","author":"Qiao","year":"2018","journal-title":"J. Int. Med. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s12941-019-0327-8","article-title":"Determining the Clinical Significance of Co-Colonization of Vancomycin-Resistant Enterococci and Methicillin-Resistant Staphylococcus Aureus in the Intestinal Tracts of Patients in Intensive Care Units: A Case\u2013Control Study","volume":"18","author":"Yoon","year":"2019","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"55","DOI":"10.5005\/jp-journals-10071-23337","article-title":"Methicillin-Resistant Staphylococcus Aureus in Intensive Care Unit Setting of India: A Review of Clinical Burden, Patterns of Prevalence, Preventive Measures, and Future Strategies","volume":"24","author":"Mehta","year":"2020","journal-title":"Indian J. Crit. Care Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.15537\/smj.2020.11.25465","article-title":"Methicillin-Resistant Staphylococcus Aureus Development in Intensive Care Patients A Case-Control Study OPEN ACCESS","volume":"41","author":"Ali","year":"2020","journal-title":"Saudi Med. J."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"4213","DOI":"10.1128\/JCM.05290-11","article-title":"Age-and Gender-Associated Staphylococcus Aureus Spa Types Found among Nasal Carriers in a General Population: The Troms\u00f8 Staph and Skin Study","volume":"49","author":"Angvik","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1128\/IAI.66.1.336-342.1998","article-title":"Intracellular Staphylococcus Aureus Escapes the Endosome and Induces Apoptosis in Epithelial Cells","volume":"66","author":"Bayles","year":"1998","journal-title":"Infect. Immun."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/11\/1\/149\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:01:21Z","timestamp":1760119281000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/11\/1\/149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,6]]},"references-count":62,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["microorganisms11010149"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms11010149","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,6]]}}}