Methicillin-Resistant<i>Staphylococcus aureus</i>Carriage and Risk Factors for Skin Infections, Southwestern Alaska, USA

Stevens, Anne M.; Hennessy, Thomas W.; Baggett, Henry C.; Bruden, Dana; Parks, Debbie; Klejka, Joseph

doi:10.3201/eid1605.090851

Cited by 20 publications

(19 citation statements)

References 26 publications

(34 reference statements)

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“…S. aureus carriage has not been reported previously in this Australian population, and Alaskan reports are from a community with high rates of methicillin-resistant S. aureus infection [17]. In other populations, S. aureus carriage is high in infants <3-months of age, but declines rapidly as carriage of the other three bacteria increases, reaching a low point at 1–2 years [18], [19].…”

Section: Discussionmentioning

confidence: 61%

Longitudinal Nasopharyngeal Carriage and Antibiotic Resistance of Respiratory Bacteria in Indigenous Australian and Alaska Native Children with Bronchiectasis

et al. 2013

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BackgroundIndigenous children in Australia and Alaska have very high rates of chronic suppurative lung disease (CSLD)/bronchiectasis. Antibiotics, including frequent or long-term azithromycin in Australia and short-term beta-lactam therapy in both countries, are often prescribed to treat these patients. In the Bronchiectasis Observational Study we examined over several years the nasopharyngeal carriage and antibiotic resistance of respiratory bacteria in these two PCV7-vaccinated populations.MethodsIndigenous children aged 0.5–8.9 years with CSLD/bronchiectasis from remote Australia (n = 79) and Alaska (n = 41) were enrolled in a prospective cohort study during 2004–8. At scheduled study visits until 2010 antibiotic use in the preceding 2-weeks was recorded and nasopharyngeal swabs collected for culture and antimicrobial susceptibility testing. Analysis of respiratory bacterial carriage and antibiotic resistance was by baseline and final swabs, and total swabs by year.Results Streptococcus pneumoniae carriage changed little over time. In contrast, carriage of Haemophilus influenzae declined and Staphylococcus aureus increased (from 0% in 2005–6 to 23% in 2010 in Alaskan children); these changes were associated with increasing age. Moraxella catarrhalis carriage declined significantly in Australian, but not Alaskan, children (from 64% in 2004–6 to 11% in 2010). While beta-lactam antibiotic use was similar in the two cohorts, Australian children received more azithromycin. Macrolide resistance was significantly higher in Australian compared to Alaskan children, while H. influenzae beta-lactam resistance was higher in Alaskan children. Azithromycin use coincided significantly with reduced carriage of S. pneumoniae, H. influenzae and M. catarrhalis, but increased carriage of S. aureus and macrolide-resistant strains of S. pneumoniae and S. aureus (proportion of carriers and all swabs), in a ‘cumulative dose-response’ relationship.ConclusionsOver time, similar (possibly age-related) changes in nasopharyngeal bacterial carriage were observed in Australian and Alaskan children with CSLD/bronchiectasis. However, there were also significant frequency-dependent differences in carriage and antibiotic resistance that coincided with azithromycin use.

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Section: Discussionmentioning

confidence: 61%

Longitudinal Nasopharyngeal Carriage and Antibiotic Resistance of Respiratory Bacteria in Indigenous Australian and Alaska Native Children with Bronchiectasis

et al. 2013

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“…However, there is a paucity of data regarding this relationship. Stevens et al 19 reported higher rates of subsequent skin and soft tissue infections among MRSA colonized subjects but the magnitude of this difference decreased with time. Nasal MRSA colonization was only positive on admission in 67% of patients admitted with confirmed MRSA infections in a study by Robicsek et al 20.…”

Section: Pathophysiology: Colonization To Infectionmentioning

confidence: 97%

Does the Nose Know? An Update on MRSA Decolonization Strategies

Abad

Pulia

Safdar

2013

Curr Infect Dis Rep

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Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is an important step in the pathogenesis of active infection and is a key factor in the epidemiology of MRSA infection. Decolonization of patients found to have MRSA carriage may be of value in certain patient populations, especially those undergoing elective surgery. However, the most commonly used agent for decolonization, mupirocin, comes with a considerable risk of resistance if widely employed. Recent studies of other novel agents for decolonization show promise but further research is necessary. This review focuses on the pathogenesis from MRSA colonization to infection, identifies the risk factors for colonization, and summarizes decolonization strategies, including novel approaches that may ave a role in decreasing MRSA disease burden.

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“…Nasal or mucocutaneous colonisation with MRSA is a potential reservoir for infection in the individual patient as well as transmission to other patients and healthcare workers [28][29][30]. However, it has been argued that nasal carriage may not be the main acquisition pathway for SSIs [31,32].…”

Section: Active Screening Of Mrsa Carriers: Universal or Targeted?mentioning

confidence: 98%

Update on screening and clinical diagnosis of meticillin-resistant Staphylococcus aureus (MRSA)

Harbarth

Hawkey

Tenover³

et al. 2011

International Journal of Antimicrobial Agents

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Methicillin-ResistantStaphylococcus aureusCarriage and Risk Factors for Skin Infections, Southwestern Alaska, USA

Abstract: Skin infection risk was increased among MRSA nasal carriers.

Cited by 20 publications

References 26 publications

Longitudinal Nasopharyngeal Carriage and Antibiotic Resistance of Respiratory Bacteria in Indigenous Australian and Alaska Native Children with Bronchiectasis

Longitudinal Nasopharyngeal Carriage and Antibiotic Resistance of Respiratory Bacteria in Indigenous Australian and Alaska Native Children with Bronchiectasis

Does the Nose Know? An Update on MRSA Decolonization Strategies

Update on screening and clinical diagnosis of meticillin-resistant Staphylococcus aureus (MRSA)

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