{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:33:52Z","timestamp":1760574832700,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bacteria"],"abstract":"<jats:p>Introduction: Colonization by Staphylococcus aureus\u2014including methicillin-resistant strains (MRSA)\u2014represents a growing public health concern, particularly in community and rural settings. In Portugal, limited data are available regarding its prevalence in populations with agricultural or animal-related exposures. Objectives: To determine the prevalence of S. aureus and MRSA nasal colonization among adults residing in the municipality of Sert\u00e3, Portugal, and to explore potential sociodemographic and behavioral factors associated with colonization. Methods: A cross-sectional study was conducted with 292 adult participants from multiple parishes of Sert\u00e3. Nasal swabs were collected for microbiological identification of S. aureus and MRSA. Data on sociodemographic characteristics, occupational exposure, animal contact, and recent antibiotic use were collected via structured questionnaires. Descriptive statistics and inferential analyses (chi-square and Fisher\u2019s exact tests) were performed, and odds ratios were estimated. Results: The overall prevalence of S. aureus colonization was 19.9% (58\/292), with MRSA detected in 4.8% (14\/292) of participants, representing 24.1% of all S. aureus carriers. Colonization by S. aureus was slightly more frequent among females (51.7%) and predominantly observed in individuals aged 35\u201359 years. MRSA was more frequent in participants aged \u2265 60 years and was equally distributed between sexes. 57% of MRSA cases reported recent antibiotic use and all MRSA cases reported daily contact with animals\u2014primarily domestic species. No statistically significant associations were identified between colonization and the analyzed variables, although trends suggested increased risk among individuals with animal contact and moderate to high-risk occupations. Conclusions: This study revealed a notable prevalence of S. aureus and MRSA colonization in a rural Portuguese population. Although no statistically significant associations were found, with animal contact, occupational exposure, and recent antibiotic use emerged as relevant epidemiological factors. These findings highlight the need for strengthened surveillance and further investigation into zoonotic transmission and occupational risk in rural environments.<\/jats:p>","DOI":"10.3390\/bacteria4040054","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T08:34:26Z","timestamp":1760517266000},"page":"54","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Community Surveillance of MRSA and Staphylococcus aureus in Rural Portugal: The BI-STAPH Project\u2014Phase 1: Sert\u00e3"],"prefix":"10.3390","volume":"4","author":[{"given":"Ainhoa","family":"Cordero","sequence":"first","affiliation":[{"name":"Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"}]},{"given":"Francisco","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9862-0691","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Coelho","sequence":"additional","affiliation":[{"name":"Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"},{"name":"Sport Physical Activity and Health Research & Innovation Center (Sprint), Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4671-4239","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Belo","sequence":"additional","affiliation":[{"name":"Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"}]},{"given":"Jo\u00e3o","family":"Metello","sequence":"additional","affiliation":[{"name":"Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3215-0244","authenticated-orcid":false,"given":"Carina","family":"Santos","sequence":"additional","affiliation":[{"name":"Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"}]},{"given":"S\u00f3nia","family":"Mateus","sequence":"additional","affiliation":[{"name":"Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"},{"name":"Sport Physical Activity and Health Research & Innovation Center (Sprint), Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6191-5912","authenticated-orcid":false,"given":"Miguel","family":"Castelo-Branco","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Beira Interior, 6201-001 Covilha, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8405-4249","authenticated-orcid":false,"given":"Francisco Jos\u00e9 Barbas","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"},{"name":"Sport Physical Activity and Health Research & Innovation Center (Sprint), Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0870-9025(11)70016-5","article-title":"Etiology and bacterial susceptibility to urinary tract infections|Etiologia e sensibilidade bacteriana em infec\u00e7\u00f5es do trato urin\u00e1rio","volume":"29","author":"Rodrigues","year":"2011","journal-title":"Rev. Port. Sa\u00fade P\u00fablica"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2765","DOI":"10.1093\/cid\/ciaa109","article-title":"Staphylococcus aureus Bacteremia","volume":"71","author":"McGuire","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1080\/21505594.2021.1878688","article-title":"Pathogenicity and virulence of Staphylococcus aureus","volume":"12","author":"Cheung","year":"2021","journal-title":"Virulence"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Ghssein, G., and Ezzeddine, Z. (2022). The Key Element Role of Metallophores in the Pathogenicity and Virulence of Staphylococcus aureus: A Review. Biology, 11.","DOI":"10.3390\/biology11101525"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"850","DOI":"10.3390\/microbiolres15020055","article-title":"Urinary tract infections in a single hospital in central Portugal, a 5-year analysis","volume":"15","author":"Branco","year":"2024","journal-title":"Microbiol. Res."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Zhang, X.L., Liu, J., Fu, P., Wang, Y.X., Fan, P.P., Zhou, J.L., Xiang, X.Q., Shen, H.L., Liu, T.Y., and Zhang, Y.Y. (2025). Epidemiological profile and antimicrobial resistance trends of Staphylococcus aureus in Chinese pediatric intensive care units from 2016 to 2022: A multi-center retrospective study. BMC Infect. Dis., 25.","DOI":"10.1186\/s12879-025-10704-0"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Rodrigues, F., Coelho, P., Mateus, S., Caseiro, A., Eideh, H., Gon\u00e7alves, T., and Branco, M.C. (2025). Decoding Urinary Tract Infection Trends: A 5-Year Snapshot from Central Portugal. Clin. Pract., 15.","DOI":"10.3390\/clinpract15010014"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Kaushik, A., Kest, H., Sood, M., Steussy, B.W., Thieman, C., and Gupta, S. (2024). Biofilm Producing Methicillin-Resistant Staphylococcus aureus (MRSA) Infections in Humans: Clinical Implications and Management. Pathogens, 13.","DOI":"10.3390\/pathogens13010076"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2116","DOI":"10.5455\/OVJ.2024.v14.i9.1","article-title":"Spread of livestock-associated methicillin-resistant Staphylococcus aureus in poultry and its risks to public health: A comprehensive review","volume":"14","author":"Khairullah","year":"2024","journal-title":"Open Vet. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.idc.2020.08.002","article-title":"Multidrug-Resistant Bacteria in the Community: An Update","volume":"34","author":"Paterson","year":"2020","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_11","first-page":"509","article-title":"Methicillin resistant Staphylococcus aureus: A brief review of virulence and resistance","volume":"72","author":"Tasneem","year":"2022","journal-title":"JPMA J. Pak. Med. Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1093\/jac\/dkn447","article-title":"A survey on public knowledge and perceptions of methicillin-resistant Staphylococcus aureus","volume":"63","author":"Easton","year":"2009","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Edwin Erayil, S., Palzer, E., and Kline, S. (2022). An evaluation of risk factors for Staphylococcus aureus colonization in a pre-surgical population. Access Microbiol., 4.","DOI":"10.1099\/acmi.0.000316"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Hu, X., Hu, K., Liu, Y., Zeng, L., Hu, N., Chen, X., and Zhang, W. (2022). Risk factors for methicillin-resistant Staphylococcus aureus colonization and infection in patients with human immunodeficiency virus infection: A systematic review and meta-analysis. J. Int. Med. Res., 50.","DOI":"10.1177\/03000605211063019"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Dai, C., Ji, W., Zhang, Y., Huang, W., Wang, H., and Wang, X. (2024). Molecular characteristics, risk factors, and clinical outcomes of methicillin-resistant Staphylococcus aureus infections among critically ill pediatric patients in Shanghai, 2016\u20132021. Front. Pediatr., 12.","DOI":"10.3389\/fped.2024.1457645"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ferreira, C., Costa, S.S., Serrano, M., Oliveira, K., Trigueiro, G., Pomba, C., and Couto, I. (2021). Clonal Lineages, Antimicrobial Resistance, and PVL Carriage of Staphylococcus aureus Associated to Skin and Soft-Tissue Infections from Ambulatory Patients in Portugal. Antibiotics, 10.","DOI":"10.3390\/antibiotics10040345"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1089\/mdr.2021.0383","article-title":"Evaluation of Methicillin-Resistant Staphylococcus aureus Carriage in the Elderly in Portugal Using Selective Enrichment Followed by Quantitative Real-Time PCR","volume":"28","author":"Almeida","year":"2022","journal-title":"Microb. Drug Resist."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Silva, V., Monteiro, A., Pereira, J.E., Maltez, L., Igrejas, G., and Poeta, P. (2022). MRSA in Humans, Pets and Livestock in Portugal: Where We Came from and Where We Are Going. Pathogens, 11.","DOI":"10.3390\/pathogens11101110"},{"key":"ref_19","unstructured":"Instituto Nacional de Estat\u00edstica (2025, May 06). Censos 2021\u2013Resultados Definitivos. Available online: https:\/\/censos.ine.pt\/xportal\/xmain?xpgid=censos21_main&xpid=CENSOS21&xlang=pt."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"van Bijnen, E.M., Paget, J., de Lange-de Klerk, E.S., den Heijer, C.D., Versporten, A., Stobberingh, E.E., Goossens, H., Schellevis, F.G., and collaboration with the APRES Study Team (2015). Antibiotic Exposure and Other Risk Factors for Antimicrobial Resistance in Nasal Commensal Staphylococcus aureus: An Ecological Study in 8 European Countries. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0135094"},{"key":"ref_21","first-page":"55","article-title":"Epidemiology of Staphylococcus aureus Nasal Carriage Patterns in the Community","volume":"398","author":"Mehraj","year":"2016","journal-title":"Curr. Top. Microbiol. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1016\/j.ijheh.2019.08.003","article-title":"Unexpected categories at risk of S. aureus nasal carriage among hospital workers","volume":"222","author":"Boisset","year":"2019","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Hasanpour, A.H., Sepidarkish, M., Mollalo, A., Ardekani, A., Almukhtar, M., Mechaal, A., Hosseini, S.R., Bayani, M., Javanian, M., and Rostami, A. (2023). The global prevalence of methicillin-resistant Staphylococcus aureus colonization in residents of elderly care centers: A systematic review and meta-analysis. Antimicrob. Resist. Infect. Control, 12.","DOI":"10.1186\/s13756-023-01210-6"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e606","DOI":"10.1016\/S2666-5247(24)00040-5","article-title":"Staphylococcus aureus colonisation and strategies for decolonisation","volume":"5","author":"Piewngam","year":"2024","journal-title":"Lancet Microbe"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s13756-024-01432-2","article-title":"Staphylococcus aureus screening and preoperative decolonisation with Mupirocin and Chlorhexidine to reduce the risk of surgical site infections in orthopaedic surgery: A pre-post study","volume":"13","author":"Portais","year":"2024","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1093\/jac\/dkt047","article-title":"Prevalence, risk factors and genetic diversity of methicillin-resistant Staphylococcus aureus carried by humans and animals across livestock production sectors","volume":"68","author":"Vandendriessche","year":"2013","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13620-021-00200-7","article-title":"Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) prevalence in humans in close contact with animals and measures to reduce on-farm colonisation","volume":"74","author":"Lawlor","year":"2021","journal-title":"Ir. Vet. J."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Leibler, J.H., Jordan, J.A., Brownstein, K., Lander, L., Price, L.B., and Perry, M.J. (2016). Staphylococcus aureus Nasal Carriage Among Beefpacking Workers in a Midwestern United States Slaughterhouse. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0148789"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Obanda, B.A., Gibbons, C.L., F\u00e8vre, E.M., Bebora, L., Gitao, G., Ogara, W., Wang, S.H., Gebreyes, W., Ngetich, R., and Blane, B. (2022). Multi-Drug Resistant Staphylococcus aureus Carriage in Abattoir Workers in Busia, Kenya. Antibiotics, 11.","DOI":"10.3390\/antibiotics11121726"},{"key":"ref_30","first-page":"105408","article-title":"Comparative review of the nasal carriage and genetic characteristics of Staphylococcus aureus in healthy livestock: Insight into zoonotic and anthroponotic clones","volume":"109","author":"Abdullahi","year":"2023","journal-title":"Infect. Genet. Evol. J. Mol. Epidemiol. Evol. Genet. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"439","DOI":"10.5604\/01.3001.0010.7038","article-title":"Prevalence, Influencing Factors, Antibiotic Resistance, Toxin and Molecular Characteristics of Staphylococcus aureus and MRSA Nasal Carriage among Diabetic Population in the United States, 2001\u20132004","volume":"66","author":"Lin","year":"2017","journal-title":"Pol. J. Microbiol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Chen, B., Li, S., Lin, S., Huang, M., and Dong, H. (2022). The Association Between Antibiotics and Community-Associated Staphylococcus aureus Colonization in the United States Population: Analysis of the National Health and Nutrition Examination Survey (NHANES). Medicine, 101.","DOI":"10.1097\/MD.0000000000031702"},{"key":"ref_33","first-page":"45","article-title":"Trojan Horse Antibiotics-A Novel Way to Circumvent Gram-Negative Bacterial Resistance?","volume":"9","author":"Tillotson","year":"2016","journal-title":"Infect. Dis. Res. Treat."}],"container-title":["Bacteria"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2674-1334\/4\/4\/54\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T09:43:11Z","timestamp":1760521391000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2674-1334\/4\/4\/54"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,13]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["bacteria4040054"],"URL":"https:\/\/doi.org\/10.3390\/bacteria4040054","relation":{},"ISSN":["2674-1334"],"issn-type":[{"value":"2674-1334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,13]]}}}