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Open Access Highly Accessed Research article

Increased prevalence of methicillin-resistant Staphylococcus aureus nasal colonization in household contacts of children with community acquired disease

Yaseen Rafee12, Nahed Abdel-Haq12*, Basim Asmar12, Tanaz Salimnia3, Celine Vidaillac Pharm4, Michael J Rybak Pharm45 and Muhammad Amjad6

Author Affiliations

1 Division of Infectious Diseases, Children's Hospital of Michigan, Detroit, MI, USA

2 Carman and Ann Adams Department of Pediatrics, Wayne State University, Detroit, MI, USA

3 Wayne State University, Detroit, MI, USA

4 Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USA

5 School of Medicine, Wayne State University, Detroit, MI, USA

6 Department of Clinical Laboratory Sciences, Marshall University, Huntington, WV, USA

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BMC Infectious Diseases 2012, 12:45  doi:10.1186/1471-2334-12-45

Published: 20 February 2012

Abstract

Background

To measure Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization prevalence in household contacts of children with current community associated (CA)-MRSA infections (study group) in comparison with a group of household contacts of children without suspected Staphylococcus aureus infection (a control group).

Methods

This is a cross sectional study. Cultures of the anterior nares were taken. Relatedness of isolated strains was tested using pulse field gel electrophoresis (PFGE).

Results

The prevalence of MRSA colonization in the study group was significantly higher than in the control group (18/77 (23%) vs 3/77 (3.9%); p ≤ 0.001). The prevalence of SA colonization was 28/77 (36%) in the study group and 16/77 (21%) in the control group (p = 0.032). The prevalence of SA nasal colonization among patients was 6/24 (25%); one with methicillin-susceptible S. aureus (MSSA) and 5 with MRSA. In the study (patient) group, 14/24 (58%) families had at least one household member who was colonized with MRSA compared to 2/29 (6.9%) in the control group (p = 0.001). Of 69 total isolates tested by PFGE, 40 (58%) were related to USA300. Panton-Valetine leukocidin (PVL) genes were detected in 30/52 (58%) tested isolates. Among the families with ≥1 contact colonized with MRSA, similar PFGE profiles were found between the index patient and a contact in 10/14 families.

Conclusions

Prevalence of asymptomatic nasal carriage of MRSA is higher among household contacts of patients with CA-MRSA disease than control group. Decolonizing such carriers may help prevent recurrent CA-MRSA infections.

Keywords:
MRSA; Children; Nasal colonization