ANKMJ
Ankyra Medical Journal

Ankyra Medical Journal (AnkMJ), formerly known as the Journal of Translational and Practical Medicine, regularly publishes international quality issues in the field of Medicine in the light of current information.

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Original Article
Colonization of Staphylococcus aureus in nasal cavities of food handlers in military
Abstract
Aims: The anterior nares constitute the primary ecological reservoir for Staphylococcus aureus in healthy individuals, with hands serving as the principal vectors for transmission. This study aimed to determine the prevalence of nasal S. aureus carriage and evaluate occupational risk factors among military personnel employed in food handling, personal care, and service delivery roles.
Methods: A retrospective analytical cross sectional study was conducted on 1,036 healthy male service personnels who presented to family medicine outpatient clinics in Ankara. Nasal swabs were cultured for S. aureus, and isolates were classified as methicillin susceptible (MSSA) or methicillin resistant (MRSA). Demographic variables and occupational sectors (service personnel, food preparation, and personal care) were recorded. Positive carriers received targeted topical antimicrobial treatment. Statistical analyses were performed using IBM SPSS v25.0, with significance defined as p < 0.05; chi square tests were utilized to assess associations, and 95% confidence intervals (CI) were provided for prevalence rates and odds ratios.
Results: The cohort median age was 21 years (QR = 4.0). Overall nasal colonization with S. aureus was 15.1% (n = 156). MSSA prevalence was 14.1% (n=146), while MRSA was identified in 1.0% (n = 10) of the sample, exclusively among service personnel. Occupational sector was a significant predictor of nasal carriage (χ²= 22.635; p < 0.001), with service delivery staff exhibiting increased odds of colonization (OR = 3.307, 95% CI: 2.152-5.081).
Conclusion: In In this military cohort, moderate S. aureus colonization contrasted with infrequent MRSA carriage. However, the elevated risk in specific sectors necessitates targeted infection control. Despite debates over universal screening, these findings justify continued surveillance and decolonization for specialized military food service personnel to mitigate transmission and safeguard public health.

Keywords : Staphylococcus aureus, nasal colonization, military personnel, food handler, MRSA, MSSA

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1. Sakr A, Brégeon F, Mège JL, Rolain JM, Blin O. Staphylococcus aureus nasal colonization: an update on mechanisms, epidemiology, risk factors, and subsequent infections. Front Microbiol. 2018;9:2419. doi:10.3389/fmicb.2018.02419
2. Bode LG, Kluytmans JA, Wertheim HF, et al. Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N Engl J Med. 2010;362(1):9-17. doi:10.1056/NEJMoa0808939
3. Honda H, Krauss MJ, Coopersmith CM, et al. Staphylococcus aureus nasal colonization and subsequent infection in intensive care unit patients: does methicillin resistance matter? Infect Control Hosp Epidemiol. 2010;31(6):584-591. doi:10.1086/652530
4. Durupt F, Mayor L, Bes M, et al. Prevalence of Staphylococcus aureus toxins and nasal carriage in furuncles and impetigo. Br J Dermatol. 2007;157(6):1161-1167. doi:10.1111/j.1365-2133.2007.08197.x
5. Wertheim HF, Melles DC, Vos MC, et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis. 2005;5(12):751-762. doi:10.1016/S1473-3099(05)70295-4
6. Tong SY, Davis JS, Eichenberger E, Holland TL, Fowler VG Jr. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015; 28(3):603-661. doi:10.1128/CMR.00134-14
7. Frank DN, Feazel LM, Bessesen MT, Price CS, Janoff EN, Pace NR. The human nasal microbiota and Staphylococcus aureus carriage. PLoS One. 2010;5(5):e10598. doi:10.1371/journal.pone.0010598
8. Muthukrishnan G, Lamers RP, Ellis A, et al. Longitudinal genetic analyses of Staphylococcus aureus nasal carriage dynamics in a diverse population. BMC Infect Dis. 2013;13:221. doi:10.1186/1471-2334-13-221
9. Zhao N, Cheng D, Yang Z, et al. Virulence adaption to environment promotes the age-dependent nasal colonization of Staphylococcus aureus. Emerg Microbes Infect. 2022;11(1):1402-1415. doi:10.1080/22221751.2022.2074316
10. Deeny SR, Cooper BS, Cookson B, Hopkins S, Robotham JV. Targeted versus universal screening and decolonization to reduce healthcare-associated meticillin-resistant Staphylococcus aureus infection. J Hosp Infect. 2013;85(1):33-44. doi:10.1016/j.jhin.2013.03.011
11. Humphreys H, Becker K, Dohmen PM, et al. Staphylococcus aureus and surgical site infections: benefits of screening and decolonization before surgery. J Hosp Infect. 2016;94:295-304. doi:10.1016/j.jhin.2016.06.011
12. Strommenger B, Layer F, Werner G. Staphylococcus aureus and methicillin-resistant Staphylococcus aureus in workers in the food industry. In: Fischetti VA, ed. Staphylococcus aureus. Academic Press. 2018:163-188. doi:10.1016/B978-0-12-809671-0.00009-7
13. Livorsi DJ, Arif S, Garry P, et al. Methicillin-resistant Staphylococcus aureus (MRSA) nasal real-time PCR: a predictive tool for contamination of the hospital environment. Infect Control Hosp Epidemiol. 2015;36(1):34-39. doi:10.1017/ice.2014.16
14. World Health Organization. Health Surveillance and Management Procedures for Food-Handling Personnel: Report of a WHO Consultation. World Health Organ Tech Rep Ser. 1989;785:1-46. Accessed March 26, 2026. http://www.who.int/iris/handle/10665/39610
15. Del Rosal T, Méndez-Echevarría A, Garcia-Vera C, et al. Staphylococcus aureus nasal colonization in Spanish children: the COSACO nationwide surveillance study. Infect Drug Resist. 2020;13:4643-4651. doi:10.2147/IDR.S282880
16. Rigaill J, Gavid M, Fayolle M, et al. Staphylococcus aureus nasal colonization level and intracellular reservoir: a prospective cohort study. Eur J Clin Microbiol Infect Dis. 2023;42(5):621-629. doi:10.1007/s10096-023-04591-z
17. Jamil J, Zaman K, Ullah S, Kalsoom A. Colonization of Staphylococcus aureus in nasal cavities of healthy individuals from district Swabi, KP, Pakistan. J Pak Med Assoc. 2020;70(7):1154-1158. doi:10.5455/JPMA.9948
18. Hu W, Wang Y, Zhou L, et al. Nasal Staphylococcus aureus carriage and antimicrobial resistance profiles among community-dwelling adults in Jiangsu, China. Infect Dis Ther. 2024;13(6):1215-1233. doi:10.1007/s40121-024-00969-4
19. Wolde W, Mitiku H, Sarkar R, Shume T. Nasal carriage rate of Staphylococcus aureus, its associated factors, and antimicrobial susceptibility pattern among health care workers in public hospitals, Harar, Eastern Ethiopia. Infect Drug Resist. 2023;16:3477-3486. doi:10.2147/IDR.S396570
20. Khanal R, Sah P, Lamichhane P, Lamsal A, Upadhaya S, Pahwa VK. Nasal carriage of methicillin resistant Staphylococcus aureus among health care workers at a tertiary care hospital in Western Nepal. Antimicrob Resist Infect Control. 2015;4:39. doi:10.1186/s13756-015-0082-3
21. De Boeck H, Vandendriessche S, Hallin M, et al. Staphylococcus aureus nasal carriage among healthcare workers in Kisangani, the Democratic Republic of the Congo. Eur J Clin Microbiol Infect Dis. 2015;34(8):1567-1572. doi:10.1007/s10096-015-2387-9
22. den Heijer CD, van Bijnen EM, Paget WJ, et al. Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S aureus, in nine European countries: a cross-sectional study. Lancet Infect Dis. 2013;13(5):409-415. doi:10.1016/S1473-3099(13)70036-7
23. Qu F, Cui E, Guo T, et al. Nasal colonization of and clonal transmission of methicillin-susceptible Staphylococcus aureus among Chinese military volunteers. J Clin Microbiol. 2010;48(1):64-69. doi:10.1128/JCM.01572-09
24. Cosgrove SE, Fowler VG Jr. Management of methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis. 2008;46(suppl 5):S386-S393. doi:10.1086/533595
25. Neyra J, Ellis M, Rocha C, et al. Prevalence of nasal colonization with Staphylococcus aureus in 4 cities in Peru. Trop Dis Travel Med Vaccines. 2016;2:12. doi:10.1186/s40794-016-0025-x
26. Todd EC, Greig JD, Bartleson CA, Michaels BS. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 6. Transmission and survival of pathogens in the food processing and preparation environment. J Food Prot. 2009;72(1):202-219. doi:10.4315/0362-028x-72.1.202
27. Aamot HV, Eskonsipo PK, Jørgensen SB, Blomfeldt A. Staphylococcus aureus colonization during military service: a prospective cohort study. Clin Microbiol Infect. 2018;24(7):744-748. doi:10.1016/j.cmi.2017.10.012
28. Kadariya J, Smith TC, Thapaliya D. Staphylococcus aureus and Staphylococcal food-borne disease: an ongoing challenge in public health. Biomed Res Int. 2014;2014:827965. doi:10.1155/2014/827965
29. Westgeest AC, Hanssen JLJ, de Boer MGJ, Schippers EF, Lambregts MMC. Eradication of community-onset methicillin-resistant Staphylococcus aureus carriage: a narrative review. Clin Microbiol Infect. 2025;31(2):173-181. doi:10.1016/j.cmi.2024.01.003
30. Hirabayashi A, Kajihara T, Yahara K, Shibayama K, Sugai M. Impact of the COVID-19 pandemic on the surveillance of antimicrobial resistance. J Hosp Infect. 2021;117:147-156. doi:10.1016/j.jhin.2021.09.011
Article available in :
Volume 5, Issue 4, 2026
Page : 97-101
https://doi.org/10.51271/ANKMJ-0076
Article Information
Received : 01 Mar 2026
Accepted : 01 Nis 2026
Published : 06 Eki 2026
Corresponding Author :

Özlem Güç Suvak: Department of Family Medicine, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Güç Suvak Ö. Colonization of Staphylococcus aureus in nasal cavities of food handlers in a military setting. Ank Med J. 2026;5(4):97-101. doi:10.51271/ANKMJ-0076

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