Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with an increased risk of infection. Colonization with MRSA is observed in < 1% of the general Dutch population. Increased risk for MRSA carriage is known to occur in several key groups, one of which is asylum seekers. However, little is known about MRSA carriage among undocumented migrants and uninsured legal residents. This study aimed to determine the prevalence of nasal MRSA carriage among these groups in Amsterdam, the Netherlands. In this cross-sectional study, between October 2018 and October 2019, undocumented migrants and uninsured legal residents aged 18 years or older who were able to understand one of the study languages were recruited at an NGO health care facility in Amsterdam, the Netherlands, for general practitioner (GP) consultations. Participants were asked questions on demographics, migration history, antibiotic use and other possible risk factors for MRSA carriage and were screened for nasal MRSA carriage by selective culturing e-swabs. Characteristics of MRSA-negative and MRSA-positive participants were compared using univariable logistic regression analysis with Firth’s correction. Of the 3822 eligible patients, 760 were screened for nasal MRSA carriage (19.9%). Of the 760 participants, over half were male (58%; 442/760) and originated mainly from Africa (35%; 267/760), Asia (30%; 229/760) and North or South America (30%; 227/760). In total, 705/760 participants (93%) were undocumented migrants and 55/760 (7%) were uninsured legal residents of Amsterdam. The overall prevalence of nasal MRSA carriage was 2.0% (15/760) (95%CI 1.1 to 3.2%), with no difference between undocumented migrants (14/705) (2.0, 95%CI 1.1 to 3.3%) and uninsured legal residents (1/55) (1.8, 95%CI 0.1 to 9.7%). Genotyping showed no clustering of the 15 isolates. MRSA carriage was not associated with sociodemographic, migration history or other possible risk factors. Nevertheless, this study had limited power to detect significant determinants. Three participants (3/15; 20%) harbored Panton-Valentine leukocidin (PVL)-positive isolates. Even though our study population of undocumented migrants and uninsured legal residents had a higher prevalence of nasal MRSA carriage compared to the general Dutch population, the prevalence was relatively low compared to acknowledged other high-risk groups.

中文翻译：

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荷兰阿姆斯特丹无证移徙者和无保险合法居民中的耐甲氧西林金黄色葡萄球菌（MRSA）鼻腔运输：一项横断面研究。

耐甲氧西林金黄色葡萄球菌（MRSA）的鼻腔运输与感染风险增加有关。在不到1％的荷兰普通人群中发现了MRSA的定植。已知在几个关键群体中发生MRSA携带风险增加，其中之一是寻求庇护者。但是，对于无证移民和无保险合法居民中的MRSA运送知之甚少。这项研究旨在确定荷兰阿姆斯特丹这些人群中鼻MRSA携带的患病率。在2018年10月至2019年10月的这项横断面研究中，能够理解其中一种研究语言的18岁以上的无证移民和无保险合法居民在荷兰阿姆斯特丹的一家NGO卫生保健机构招募，用于全科医生（GP）咨询。询问参与者有关人口统计学，迁移史，抗生素使用和其他可能携带MRSA的危险因素的问题，并通过选择性培养电子拭子筛选鼻MRSA携带情况。使用Firth校正的单变量logistic回归分析比较MRSA阴性和MRSA阳性参与者的特征。在3822名合格患者中，有760名接受了鼻MRSA转运筛查（19.9％）。在760名参与者中，一半以上为男性（58％； 442/760），主要来自非洲（35％； 267/760），亚洲（30％； 229/760）和北美或南美（30％； 227） / 760）。总共705/760名参与者（93％）是无证移民，而55/760名参与者（7％）是阿姆斯特丹的未投保合法居民。鼻MRSA转运的总体患病率为2.0％（15/760）（95％CI为1.1至3.2％），无证移民（14/705）（2.0，95％CI 1.1至3.3％）和无保险合法居民（1/55）（1.8，95％CI 0.1至9.7％）之间没有差异。基因分型显示15个分离株没有聚类。MRSA携带与社会人口统计学，迁移历史或其他可能的风险因素无关。但是，这项研究检测重要决定因素的能力有限。三名参与者（3/15； 20％）携带Panton-Valentine leukocidin（PVL）阳性分离株。尽管我们的无证移民和无保险合法居民的研究人群与荷兰普通人群相比，鼻MRSA携带率更高，但与公认的其他高风险人群相比，其患病率相对较低。基因分型显示15个分离株没有聚类。MRSA携带与社会人口统计学，迁移历史或其他可能的风险因素无关。但是，这项研究检测重要决定因素的能力有限。三名参与者（3/15； 20％）携带Panton-Valentine leukocidin（PVL）阳性分离株。尽管我们的无证移民和无保险合法居民的研究人群与荷兰普通人群相比，鼻MRSA携带率更高，但与公认的其他高风险人群相比，其患病率相对较低。基因分型显示15个分离株没有聚类。MRSA携带与社会人口统计学，迁移历史或其他可能的风险因素无关。但是，这项研究检测重要决定因素的能力有限。三名参与者（3/15； 20％）携带Panton-Valentine leukocidin（PVL）阳性分离株。尽管我们的无证移民和无保险合法居民的研究人群与荷兰普通人群相比，鼻MRSA携带率更高，但与公认的其他高风险人群相比，其患病率相对较低。20％）带有Panton-Valentine leukocidin（PVL）阳性分离株。即使我们的无证移民和无保险合法居民的研究人群与荷兰普通人群相比，鼻MRSA携带率更高，但与公认的其他高风险人群相比，其患病率相对较低。20％）带有Panton-Valentine leukocidin（PVL）阳性分离株。尽管我们的无证移民和无保险合法居民的研究人群与荷兰普通人群相比，鼻MRSA携带率较高，但与公认的其他高风险人群相比，其患病率相对较低。