Prevalence and Molecular Characterization of S. aureus and MRSA on Children's Playgrounds.

Background: Staphylococcus aureus is a major public health concern due to the emergence of virulent and drug-resistant strains such as methicillin-resistant Staphylococcus aureus (MRSA). Although numerous studies have been conducted to assess the environmental contamination of S. aureus in health care and household settings, little is known about the prevalence and epidemiology of S. aureus, including MRSA, on environmental surfaces of children's playgrounds. This study investigated the prevalence and molecular epidemiology of S. aureus and MRSA at playgrounds in northeast Ohio. Methods: A total of 280 environmental samples were collected from 10 playgrounds in northeast Ohio in July 2016. Sampling sites were selected based on playground size and availability of equipment located in both small and large cities and their suburbs. Samples were analyzed using established microbiology methods, and resulting S. aureus isolates were typed by spa typing. Polymerase chain reaction was used to detect the presence of the Panton-Valentine leukocidin and mecA genes. Antibiotic susceptibility was tested via the Vitek-2 System. Results: The overall prevalence of S. aureus and MRSA was 31.8% (89/280) and 3.9% (11/280), respectively. A total of 43 spa types were detected from 257 S. aureus isolates. Overall, t189 was the most common spa type, accounting for 15.6% (40/257) of the isolates. Sixteen isolates (6.2%) were t002 (ST5/USA100), a common hospital-associated strain, and 11 isolates (4.3%) were t008 (ST8/USA300), a common communityassociated strain. Five livestock-associated strain (t571/ST398) were also identified. Twenty-nine (11.3%) isolates were resistant to oxacillin, and 66 (25.7%) were multi-drug resistant S. aureus. Conclusions: The results of this study indicate that environmental surfaces of playgrounds in northeastern Ohio were contaminated with S. aureus and MRSA. These data reinforce the need for implementing effective prevention strategies to mitigate the risk imposed to children by environmental contamination of MRSA.