Journal of Applied Microbiology ISSN 1364-5072

ORIGINAL ARTICLE

Characterization of Methicillin-resistant Staphylococcus

aureus isolated from public surfaces on a University
Campus, Student Homes and Local Community
M.C. Roberts, O.O. Soge, D. No, S.E. Helgeson and J.S. Meschke
Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA

Keywords
environmental surfaces, methicillin-resistant
Staphylococcus aureus, student home
surfaces, university surfaces.
Correspondence
Marilyn C. Roberts, Department of
Environmental and Occupational Health
Sciences, 357234, School of Public Health,
University of Washington, Seattle, WA 98195-
7234, USA.
E-mail: marilynr@u.washington.edu
2011 ⁄ 0157: received 26 January 2011,
revised 27 February 2011 and accepted 14
March 2011
doi:10.1111/j.1365-2672.2011.05017.x
Abstract
Aim: Isolation and characterization of methicillin-resistant Staphylococcus aur-
eus (MRSA) from frequently touched nonhospital environmental surfaces at a
large university, student homes and community sites.
Methods and Results: Twenty-four isolates from 21 (4Æ1%, n = 509) surfaces
were MRSA positive and included 14 (58%, n = 24) SCCmec type IV, two
(8%, n = 24) type I, and eight (33%, n = 24) were not type I-IV (NT). Six
different multilocus sequencing types were identified by PCR and sequencing.
PCR assays identified one (4Æ2%, n = 24) Panton-Valentine leukocidin (PVL)
positive, 22 (92%, n = 24) arginine catabolic mobile element (ACME) positive
and 23 (96%, n = 24) multidrug-resistant (kanamycin, macrolide, tetracycline)
MRSA isolates. Eleven (46%, n = 24) USA300 isolates were determined by
pulsed-field gel electrophoresis.
Conclusion: The MRSA-positive environmental surfaces were identified in stu-
dent homes (11Æ8%, n = 85), the community (2Æ3%, n = 130) and the univer-
sity (2Æ7%, n = 294). USA300 strains were isolated from the university, student
homes and community samples. This is the first report of the animal clone
ST97 on urban environmental surfaces.
Significance and Impact of the Study: The study highlights the distribution of
USA300 on frequently touched surfaces. Whether contact with these MRSA
contaminated environmental surfaces are associated with increased risk of
transmission of MRSA to people needs further research.

There are less therapeutic options for treatment of MRSA

Introduction
Staphylococcus aureus is carried in the nose of 25–35% of
humans, and it is a common cause of serious and life-
threatening infections. Methicillin-resistant S. aureus
[MRSA] was first identified fifty years ago, and today, it
has become a major nosocomial pathogen. Community-
acquired MRSA (CA-MRSA) skin and soft tissue infec-
tions, normally associated with USA300 MRSA strains in
North America, are on the increase in healthy people with
no healthcare exposure or known classical risk factors
(Eady and Cove 2003; Klevens et al. 2007). Identified risk
factors associated with CA-MRSA outbreaks include
sharing of personal care products, frequent skin-to-skin
contact, skin abrasions and crowded living conditions.
infections, patients often require longer hospital stays,
and MRSA infections are more likely to recur which
increases the costs as compared to infections because of
S. aureus (Rubin et al. 1999).
Staphylococcus aureus and MRSA are spread from
people-to-people and fomite-to-person, although the
potential reservoirs in the community are unknown (Eady
and Cove, 2003; Miller and Diep 2008). MRSA-contami-
nated public transport handrails (Stepanović et al. 2008),
beauty salon surfaces (Huijsdens et al. 2008), fire stations,
medic trucks and ambulance surfaces have been identified
(Brown et al. 2010; Roberts et al. 2011b; Roline et al.
2007). Scott et al. (2009) found MRSA contaminated
surfaces in nine (26%) of 35 homes with MRSA isolated

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Journal of Applied Microbiology 110, 1531–1537 ª 2011 The Society for Applied Microbiology 1531
MRSA from environmental nonhospital surfaces
from seven of 13 kitchen surfaces and four of 11 bath-
room surfaces, and methicillin-susceptible S. aureus
[MSSA] was isolated from 12 of the kitchen and ten of
the bathroom surfaces. One study found that environ-
mental survival of MRSA improves in the presence of
organic material on coins (Tolba et al. 2007). While a
second study (Desai et al. 2009) showed MRSA may per-
sist on contaminated surfaces for >5 weeks, suggesting
that MRSA may survive for extended time periods. The
second study also determined that 3 s of skin contact
with a MRSA-contaminated surface or object was all that
was required to transfer MRSA to the skin under labora-
tory conditions.
Brook et al. (2009) examined 70 frequently used
environmental surfaces in a university of 25 000 indi-
viduals for contamination of S. aureus and MRSA from
420 samples taken from student desktops, computer
keyboards, telephone mouthpieces, water fountains, pho-
tocopy keypads, vending machines and elevators buttons
over a 3-week period in 2007. Staphylococcus aureus was
isolated from computer keyboards, telephones and eleva-
tor buttons; however, no MRSA strains were isolated and
S. aureus were not further characterized. More recently
we have found 8Æ4% of the 95 environmental surfaces
taken from university dental clinics were MRSA positive.
In that study, three MRSA were SCCmec type IV, three
were Panton-Valentine leukocidin positive (PVL+) and
none were USA300 (Roberts et al. 2011a). This study sug-
gested that both dental clinic surfaces and dental students
may be reservoirs for MRSA, although the dental clinic
services outpatients and thus is more related to a hospital
setting than strictly a university environment.
In the current study, 24 MRSA isolates were identified
and characterized from 21 (4Æ1%, n = 509) environmental
surfaces taken from a large university campus, student
homes and the local community. Fourteen (58%, n = 24)
MRSA were type IV, two (8%, n = 24) type I and eight
(33%, n = 24) NT, and 11 (46%, n = 24) isolates from all
three sampled areas were USA300. In contrast to earlier
studies, 23 of 24 of the MRSA isolates in this study were
resistant to ‡1 other class of antibiotics which would
reduce therapeutic options if they caused disease (Eady
and Cove, 2003). MRSA-positive surfaces were identified
in all three locations (student homes, community and
university), suggesting that these contaminated surfaces
may be reservoirs for transmission of MRSA to the public.
Materials and methods
Surfaces sampled
A total of 509 frequently touched surfaces including 85
environmental samples from eight undergraduate student
1532 Journal of Applied Microbiology 110, 1531–1537 ª 2011 The Society for Applied Microbiology
M.C. Roberts et al.
housing sites (apartments, houses, parent homes and
dorm rooms) including common areas (couch, bathroom
surfaces, kitchen, microwave touchpad, TV remote, wash-
ing machine) using the Scott et al. study (2009) as a
guide, and students cell phones; 294 surfaces on Univer-
sity of Washington (UW) campus (ATM and computer
keypads, bathroom handles, elevator buttons, locker
handles, vending machine keypads, and water fountain
handles, gym equipment); and 130 community sites
(parking meters, ATM keypads, public library touch
screens) were sampled in 2009–2010 (Table 1). The Uni-
versity has >43 000 students and 22 000 employees.
Two of the indoor UW ATM keypads were sampled nine
separate times over a 6-month time period for the
presence of MSSA and MRSA (Table 2). While the other
sites were sampled once using the SANICULTTM swab
(Starplex Scientific Inc., Etobicoke, ON, Canada) or
BBLTM RODACTM contact plates (Becton Dickinson Co.,
Franklin Lakes, NJ, USA) for all surfaces and sterile baby
wash clothes in the washing machines as previously
described (Roberts et al. 2011a). A convenience sampling
plan was used.
Sample processing
BBLTM RODACTM contact plates (Becton Dickinson Co.)
with Bacto Staphylococcus Medium 110 supplemented
with 10 lg ml)1 methicillin and 0Æ01% potassium tellurite
were incubated in 5% CO2 at 36Æ5 C. Two millilitres of
Bacto m Staphylococcus broth [1Æ5·] (Difco Labora-
tories, Sparks, MD, USA) supplemented with a final
concentration of 75 lg ml)1 polymyxin B and 0Æ1%
potassium tellurite (Sigma Co. St. Louis, MO, USA) was
added to the swabs and 50 ml of media for the wash
clothes. All were incubated in 5% CO2 at 36Æ5C until
turbid and black as previously described (Roberts et al.
2011a,b). Positive samples were diluted and plated onto
Bacto m Staphylococcus Medium 110 supplemented
with 10 lg ml)1 methicillin and 0Æ01% potassium tellurite
and Bacto Mannitol Salts Agar (Difco) as previously
described (Roberts et al. 2011a,b). All samples were held
for 7 days before being labelled as negative. Isolates were
biochemically verified as S. aureus, and the mecA gene
was verified in the MRSA isolates as previously described
(Roberts et al. 2011a; Soge et al. 2009).
Detection of mecA, PVL gene, SCCmec typing,
multilocus sequence typing (MLST), and presence of the
arginine catabolic mobile element (ACME)
The PCR assay conditions for the mecA, SCCmec type
I-V, and presence of the PVL gene used previously
described primers and conditions (Roberts et al. 2011a;
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M.C. Roberts et al. MRSA from environmental nonhospital surfaces

Table 1 Molecular typing characteristics of methicillin-resistant Staphylococcus aureus isolated from 21 public surfaces

ST USA
Isolate Year Location SCCmec type PFGE 300* ACME Resistance genes

Student Homes n = 10 isolates

Student #1
J-5 2010 Dorm water fountain NT 8 M No + None
Student #2
A3-6 2010 Microwave touchpad IV 45 N No + tet(M), msr(A), aadD
A4-3 2010 Couch armrest, fabric IV 45 N No + tet(M), msr(A), aadD
Student #3
S3-23 2010 TV remote IV 5 A Yes + tet(M), tet(K), msr(A), aadD
S9-18 2010 Bathroom floor IV 5 A Yes + tet(M), msr(A), aadD
S5-28 2010 Bathroom light switch NT 5 A Yes + tet(M), tet(K), aadD
Student #4
R501 2010 Couch IV 8 K Yes + tet(M), msr(A), aadD
R502 2010 Toilet Flush Handle IV 931 K Yes + tet(M), tet(K), msr(A), aadD
R509 2010 Bathroom Door Knob IV 931 K Yes + tet(M), tet(K), msr(A), aadD
Student #5
T4-38 2010 Washing Machine IV 5 L No + tet(M), tet(K), msr(A), aadD
University Campus n = 10 isolates
3-22 2009 Bathroom 3rd floor NT 5 E No ) tet(M)
3-36 2009 Bathroom 3rd floor IV 5 A Yes + erm(C), msr(A)
20 2010 Inside ATM Keypad R IV 5 A Yes + tet(M), tet(K), erm(A), erm(C),
msr(A), aadD
36 2010 Inside ATM Keypad R I 45 D No + tet(M), tet(K), erm(A),
erm(C), aadD
26 2010 Inside ATM Keypad T IV 30 C Yes + tet(M), tet(K), erm(A), erm(C),
msr(A), aadD
8-509§ 2009 Locker handle IV 8 B Yes + tet(M), tet(K), msr(A), aadD
3-2– 2009 Elevator button I 8 F No + tet(M), erm(C), msr(A)
3-8– 2009 Elevator button NT 97 H No + tet(M)
3-10 2009 Study lounge floor NT 97 H No + tet(M), erm(C)
3-6 2009 Bathroom 2nd floor NT 97 G No ) tet(M)
Community sites near the University campus n = 4 isolates
40 2009 Outside ATM Keypad A NT 5 A Yes + tet(M), msr(A)
55 2009 Outside ATM Keypad B IV 8 I No + tet(M), erm(C), msr(A), aadD
5-3** 2010 Library computer touch screen NT 30 J No + tet(K), aadD
5-4** 2010 Library computer touch screen IV 30 J No + tet(M), tet(K), msr(A), aadD

*‡ 80% PFGE identity with USA 300 determined by BioNumerics GelCompar II software; ,–,** From the same sample;
Same ATM keypad sampled at two different time periods; #20 was isolated 4 ⁄ 02 ⁄ 10 and #36 was isolated 4 ⁄ 15 ⁄ 10 (see Table 2);
§PVL positive isolate.

Soge et al. 2009). Positive and negative controls were used
as previously described in all assays. Those isolates that
were not type I-V were labelled nontypeable [NT] for the
current study. The PCR assay for the ACME encoded
arcA gene used primers and conditions described by Diep
et al. (2006) with a clinical USA300 as the positive
control. The MLST PCR assays were performed as previ-
ously described using published primers and conditions
(Enright et al. 2000; Roberts et al. 2011a; Soge et al. 2009).
Detection of antibiotic resistance genes
PCR assays were used to determine the presence of kana-
mycin resistance gene, aadD; macrolide resistance genes,
erm(A), erm(B), erm(C), and msr(A) genes; and tetra-
cycline resistance genes, tet(M) and tet(K), with verifica-
tion by hybridization using internal 32P-labelled probe.
Positive and negative controls were used for all PCR
assays as previously described (Roberts et al. 2011a; Soge
et al. 2009).
Pulsed-field gel electrophoresis (PFGE)
Methicillin-resistant S. aureus isolates were PFGE typed
using previously described protocol (McDougal et al.
2003) with SmaI enzyme (Fermentas Inc., Glen Burnie,
MD, USA). The different PFGE patterns were labelled A
through N (Table 1). The genetic relatedness of the

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Journal of Applied Microbiology 110, 1531–1537 ª 2011 The Society for Applied Microbiology 1533
MRSA from environmental nonhospital surfaces M.C. Roberts et al.

Table 2 Methicillin-susceptible Staphylococcus aureus [MSSA] and the isolates carried tetracycline resistance genes [11
methicillin-resistant S. aureus [MRSA] from two indoor university ATM tet(M); 10 tet(K) and tet(M); 1 tet(K)]. Eighteen (75%,
machines
n = 24) carried macrolide resistance genes with 12 (50%,
Date MSSA MRSA n = 24) carrying one antibiotic resistance gene and six
(25%, n = 24) carrying ‡2 macrolide resistance genes.
ATM #R
Fifteen isolates carried the msr(A) gene, seven isolates
3 ⁄ 25 ⁄ 10 No No
4 ⁄ 2 ⁄ 10 No Yes
carried the erm(C) gene and three isolates carried the
4 ⁄ 8 ⁄ 10 No No erm(A) gene. Sixteen (67%, n = 24) of the MRSA iso-
4 ⁄ 15 ⁄ 10 No Yes lates carried the aminoglycoside resistance gene, aadD
4 ⁄ 22 ⁄ 10 No No (Table 1).
4 ⁄ 29 ⁄ 10 No No
6 ⁄ 2 ⁄ 10 No No
8 ⁄ 4 ⁄ 10 Yes No Student homes
9 ⁄ 12 ⁄ 10 No No
ATM #T
Five (63%, n = 8) undergraduate student homes had
3 ⁄ 25 ⁄ 10 Yes No MRSA-positive samples (Table 1). The MRSA-positive
4 ⁄ 2 ⁄ 10 No Yes homes included two students who were living in their
4 ⁄ 8 ⁄ 10 No No family home and three living with other students. The
4 ⁄ 15 ⁄ 10 No No three student homes that were negative for MRSA also
4 ⁄ 22 ⁄ 10 No No lived with other students. The number of MRSA-positive
4 ⁄ 29 ⁄ 10 No No
samples ranged from one to three of the 10 surfaces sam-
6 ⁄ 2 ⁄ 10 No No
8 ⁄ 4 ⁄ 10 Yes No
pled per home. Four different ST-types were identified
8 ⁄ 20 ⁄ 10 Yes No with two homes having ST5 or ST8 and two homes
9 ⁄ 12 ⁄ 10 No No (Student #3 and #4) were contaminated with USA300
isolates. Student #5 was the only one to have a MRSA-
positive washing machine. The two MRSA isolated from
Student #2 house surfaces were indistinguishable from
isolates to USA300 was determined by Dice coefficient, each other by all typing methods suggesting they repre-
UPGMA using the GelCompar II software according to sented a single strain. Diversity was found in the SCCmec
the manufacturers’ instructions (Applied Maths, Inc., type, ST type, and number and type of antibiotic resis-
Austin, TX USA). Strains that had ‡80% homology with tance genes carried by the three MRSA isolates recovered
USA300 were classified as USA300 (Table 1). from each of the Student #3 and Student #4 households.
However, the three isolates from each household had
indistinguishable PFGE patterns and were related to
Results
USA300. The USA300 MRSA isolates from Student #3
home had the same ST type, indistinguishable PFGE pat-
Identification and characterization of MRSA-positive
tern, and two of the isolates had the same SCCmec type
samples
IV as the university isolates 3-36 from the bathroom floor
Twenty-four MRSA isolates were identified from 21 and 20 from the ATM keypad, although they differed in
(4Æ1%, n = 509) different environmental surface samples, the number of other antibiotic resistance genes they car-
and included ten (11Æ8%, n = 85) student house samples, ried. All 10 MRSA isolates from the student homes were
eight (2Æ7%, n = 294) university samples and three (2Æ3%, ACME +, nine (90%, n = 10) isolates carried other anti-
n = 130) community samples (Table 1). Fourteen (58%, biotic resistance genes and none were PVL + (Table 1).
n = 24) of the MRSA isolates were SCCmec type IV of
which nine were (‡80% homology) USA300. Two addi-
University surfaces
tional isolates, which were SCCmec NT, were also
USA300. Two (8%, n = 24) isolates were SCCmec type I, Two university ATM keypads were repeatedly sampled
the remaining eight (33%, n = 24) were NT and none of nine times over a 6-month time period (Table 2). During
these were USA300. The 24 MRSA represented six differ- that time period, the ATM #R keypad was positive 3
ent ST types with the most common ST 5 (eight isolates), (33%, n = 9) times for S. aureus including twice for
followed by ST8 (five isolates), ST30, ST40 and ST97 MRSA and MSSA, while ATM #T was positive 4 (44%,
(three isolates each) and ST931 (two isolates). Twenty- n = 9) for S. aureus including once with MRSA and three
three (96%, n = 24) of the MRSA isolates carried other times with MSSA (Table 2). All three of the ATM MRSA
antibiotic resistance genes. Twenty-two (92%, n = 24) of differed in ST type (ST5, ST30, ST45), PFGE patterns and

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1534 Journal of Applied Microbiology 110, 1531–1537 ª 2011 The Society for Applied Microbiology
M.C. Roberts et al.
number of different antibiotic resistance genes carried. All
three were ACME positive and isolates 20 and 26 were
USA300 (Table 1).
Five other university samples were MRSA positive and
represented three different ST types (ST5, ST8, ST97).
Each of these isolates carried ‡1 other antibiotic resis-
tance gene(s). Isolate 8–509 was ST8, PVL+, SCCmec type
IV, USA300 and carried aminoglycoside, macrolide and
tetracycline resistance genes (Table 1). Two university
samples contained two different MRSA strains each [3-22,
3-36 and 3-2, 3-8]. The isolates 3-22, 3-36 differed from
each other by SCCmec type (IV vs NT), differed by PFGE
profile, relatedness to USA300, the presence of the ACME
element and the number of antibiotic resistance genes
carried and likely represent different strains even though
both were ST5 (Table 1). The second two isolates, 3-2,
3-6, differed by SCCmec type (I vs NT), ST type (ST8 vs
ST97), PFGE profile and the number of antibiotic resis-
tance genes carried and likely represent different strains.
Community surfaces
From the 130 community surfaces, 120 of the samples
were taken from ATM keypads sampled in 2009 and 2010
and ten were from other surfaces (Table 1). Two of 120
(1Æ7%) ATM keypad samples were MRSA positive and 11
of 120 (9Æ2%) were MSSA positive. The two MRSA iso-
lates differed in SCCmec type (IV vs NT), ST type (ST5 vs
ST8), PFGE pattern and antibiotic resistance genes they
carried. One strain #40 was USA300, while the second
strain #55 was not related to USA300 (Table 1). The two
MRSA isolates, 5-3 and 5-4, from the library computer
touch screen came from the same sample and were
SCCmec type IV, ST30, and had the same PFGE pattern,
suggesting that they represented a single strain even if
though the isolates differed in the number of antibiotic
resistance genes each carried.
Discussion
This is one of the first studies to isolate and molecularly
characterize MRSA from nonhealthcare environmental
surfaces. SCCmec typeable isolates [I or IV] were found
in 66% of the isolates, with 46% of the isolates USA300
and 92% ACME +. The five of the six MLST types (ST5,
ST8, ST30, ST45, ST931) found in the current study are
associated with humans and include widely disseminated
ST types of CA-MRSA found throughout the world
(Tavares et al. 2010; te Witt et al. 2009). In contrast,
ST97 is closely associated with cattle and more recently
described in both healthy and diseased pigs, although it
has not been found contaminating food nor associated
with humans as ST398 has (Gomez-Sanz et al. 2010;
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Journal of Applied Microbiology 110, 1531–1537 ª 2011 The Society for Applied Microbiology
MRSA from environmental nonhospital surfaces
Lozano et al. 2009). This is the first report of the animal
clone ST97 contaminating urban environmental surfaces.
Finding three animal associated isolates contaminating an
urban University environment was unexpected especially
because the ST97 isolates (3-8, 3-10 and 3-6) were taken
from three different University Campus Sites. Two of the
isolates, 3-8 and 3-10, likely represent a single clone sug-
gesting a common source, while the third isolate was
unrelated. The university is a commuter school with stu-
dents, staff and faculty travelling from surrounding urban
and rural communities. Thus, the possibility that the
three ST97 MRSA isolates originated in animals and ⁄ or
food and were transferred to the contaminated surfaces in
the study is an intriguing hypothesis although it would be
difficult to prove.
Early studies on community-acquired USA300 found
that these isolates were usually susceptible to other classes
of antibiotics (Eady and Cove 2003). However, in a more
recent study in fire stations, environmental USA300 iso-
lates were multidrug resistant as was found in the current
study (Roberts et al. 2011b). Among all the MRSA
isolates, 23 (96%, n = 24) carried ‡1 other antibiotic
resistance gene(s) with 92%, n = 24 carrying tetracycline,
and 79%, n = 24 carrying macrolide resistance genes and
similar to what has previously been found on other high-
touched environmental surfaces (Roberts et al. 2011b).
USA300 MRSA was isolated from university, student
homes and the community environmental samples.
Five (63%, n = 8) student homes had 1–3 MRSA-
positive samples and included both students who lived in
their family homes and students living with multiple stu-
dent roommates. Although this is a very small study, it
was >2-fold higher than what was identified by Scott
et al. (2009) which identified MRSA in nine (26%) homes
samples (Scott et al. 2009). In the current study, three of
the homes had multiple samples that were MRSA posi-
tive. Of the five homes, two were contaminated with
USA300 strains, and four of five homes had MRSA with
SCCmec type IV. The MRSA isolates from Student #2
home were indistinguishable from each other, suggesting
they represented the same strain from two different sam-
ples. The MRSA isolates from Student # 3 and #4 homes
did differ, but overall the data suggest that the isolates
from each home were clonally related. The MRSA isolates
from Student # 3 home were genetically related to two of
the university campus MRSA isolates; however, because
they were all USA300, it is unclear whether the home and
university isolates shared a common source. The Scott
et al.’s (2009) study did not characterize the MRSA
isolates recovered, so it is unknown whether the same
strain was found in multiple locations within the MRSA-
positive homes, or whether any of the isolates were
SCCmec type IV or USA300.
1535
MRSA from environmental nonhospital surfaces
None of the students that sampled their homes had a
MRSA infection although one student (#2) was colonized
with a MRSA strain that was genetically distinct in all
characteristics from the home isolates (unpublished data).
In the current small study, the undergraduate student
MRSA carriage rate was 12Æ5% which was higher than a
previous study among Texas University students of 7Æ3%
carriage rate (Rohde et al. 2009), but lower than the 21%
carriage rate found in dental students (Roberts et al.
2011a). A larger study examining more college students
and student houses is needed to determine whether
college students are at increased risk of MRSA infection.
MRSA-positive university samples were found from the
bathroom, floors, ATM keypads, elevator buttons, locker
handles but not on computer keyboards. One isolate was
PVL+ USA300, 3 PVL-USA300 isolates, two type I, and
four NT isolates were identified from the university sites.
All isolates were multidrug resistant and eight were
ACME+. In contrast, Kassem et al. (2007) found 8% of
the 24 university computer keyboards were MRSA positive
although they did not characterize the isolates. In contrast,
in a second university study, no MRSA were identified
from 70 frequently used environmental surfaces, although
MSSA was isolated in computer keyboards, telephone
mouthpieces and an elevator button of a large Midwestern
United States urban university (Brook et al. 2009).
Multiple sampling of two high use university ATM
machines illustrated frequent (38%) contamination with
MSSA and MRSA, with USA300 found in two of the
three isolates. This was three times higher than the 10Æ9%
MSSA and MRSA level found among community ATM
machines. Why there were such differences in frequency
of MSSA and MRSA between the university and commu-
nity ATM machines is not clear, and further sampling is
needed. The number of other community surfaces sam-
pled was limited in the current study with only computer
touch screens from a public library positive. A recent pre-
vious study sampled 118 hand-touched surfaces in buses,
trains, stations, hotels and public areas of hospital in cen-
tral London and cultured MSSA from 8% of the sites but
did not find MRSA (Otter and French 2009). Whether
contact with these MRSA contaminated environmental
surfaces are associated with increased risk of transmission
of MRSA to people is unknown. However, this study
indicates that nonhospital environmental surfaces are
potential reservoirs for MRSA.
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