OBJECTIVES Skin and soft tissue infections (SSTIs) are a serious health issue for military personnel. Of particular importance are those caused by methicillin-resistant Staphylococcus aureus and Panton-Valentine leucocidin (PVL)-positive S. aureus (PVL-SA), as they have been associated with outbreaks of SSTIs. A prospective observational study was conducted in Royal Marine (RM) recruits to investigate the prevalence of PVL-SA carriage and any association with SSTIs. METHODS A total of 1012 RM recruits were followed through a 32-week training programme, with nose and throat swabs obtained at weeks 1, 6, 15 and 32. S. aureus isolates were characterized by antibiotic susceptibility testing, spa typing, presence of mecA/C and PVL genes. Retrospective review of the clinical notes for SSTI acquisition was conducted. RESULTS S. aureus colonization decreased from Week 1 to Week 32 (41% to 26%, p < 0.0001). Of 1168 S. aureus isolates, three out of 1168 (0.3%) were MRSA and ten out of 1168 (0.9%) PVL-positive (all MSSA) and 169 out of 1168 (14.5%) were resistant to clindamycin. Isolates showed genetic diversity with 238 different spa types associated with 25 multi-locus sequence type (MLST) clonal complexes. SSTIs were seen in 35% (351/989) of recruits with 3 training days lost per recruit. SSTI acquisition rate was reduced amongst persistent carriers (p < 0.0283). CONCLUSIONS Nose and throat carriage of MRSA and PVL-SA was low among recruits, despite a high incidence of SSTIs being reported, particularly cellulitis. Carriage strains were predominantly MSSA with a marked diversity of genotypes. Persistent nose and/or throat carriage was not associated with SSTI acquisition. Putative person-to-person transmission within troops was identified based on spa typing requiring further research to confirm and explore potential transmission routes.

中文翻译：

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皇家海军陆战队新兵中金黄色葡萄球菌的定植和皮肤及软组织感染的获得：一项前瞻性队列研究。

目的皮肤和软组织感染（SSTI）对于军事人员来说是一个严重的健康问题。特别重要的是那些由耐甲氧西林的金黄色葡萄球菌和潘顿-华伦特白蛋白球菌素（PVL）阳性的金黄色葡萄球菌（PVL-SA）引起的疾病，因为它们与SSTI的爆发有关。在皇家海军（RM）的新兵中进行了一项前瞻性观察研究，以调查PVL-SA运载的普遍性以及与SSTI的任何关联。方法总共1012名RM受试者接受了为期32周的培训计划，并在第1、6、15和32周获得了鼻和咽拭子。金黄色葡萄球菌的分离物通过抗生素敏感性测试，水疗分型，mecA的存在来表征。 / C和PVL基因。对SSTI收购的临床记录进行了回顾性审查。结果S. 从第1周到第32周，金黄色葡萄球菌的数量减少（41％至26％，p <0.0001）。在1168株金黄色葡萄球菌中，MRSA占1168株中的3株（0.3％），PVL阳性（全部MSSA）中1168株（0.9％）中的10株对克林霉素耐药。1168株中的169株（14.5％）具有耐药性。分离物显示出具有238种不同温泉类型的遗传多样性，这些温泉类型与25种多位点序列类型（MLST）克隆复合体相关。在35％（351/989）的新兵中发现了SSTI，每位新兵损失了3天的培训时间。永久性携带者的SSTI采集率降低（p <0.0283）。结论尽管报道了SSTI的发生率很高，特别是蜂窝织炎，但新兵的MRSA和PVL-SA的鼻子和喉咙携带率较低。运输菌株主要是MSSA，具有明显的基因型多样性。持续的鼻子和/或咽喉运输与SSTI的获取无关。根据水疗中心的类型确定了部队中人与人之间的可能传播，需要进一步研究以确认和探索潜在的传播途径。