Methicillin-resistant Staphylococcus aureus colonization in a pediatric intensive care unit: Risk factors

Horowitz, Ira; Baorto, Elizabeth; Cirillo, Tuesday; Davis, J. Lucian

doi:10.1016/j.ajic.2011.03.027

Cited by 19 publications

(9 citation statements)

References 23 publications

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“…In addition, in hospitalized, MRSA-colonized children antecedents of antibiotic usage ( p = 0.007) and contact with healthcare workers ( p = 0.029) were significant; in contrast, for children at DCCs, previous exposure to cigarette smoke ( p = 0.010) and sharing a dwelling with children younger than 10 years ( p = 0.0493) were the most frequent characteristics detected. These findings coincide with previous reports that show that colonization by MRSA is associated to characteristics such as male gender [11], previous history of hospitalization and surgery [42], previous contact with healthcare workers [8], [11], sharing personal objects [38] overcrowding conditions and high physical contact among children [37].…”

Section: Resultssupporting

confidence: 91%

Differences in Epidemiological and Molecular Characteristics of Nasal Colonization with Staphylococcus aureus (MSSA-MRSA) in Children from a University Hospital and Day Care Centers

et al. 2014

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BackgroundClinical significance of Staphylococcus aureus colonization has been demonstrated in hospital settings; however, studies in the community have shown contrasting results regarding the relevance of colonization in infection by community-associated MRSA (CA-MRSA). In Colombia there are few studies on S. aureus colonization. The aim of this study was to determine the molecular and epidemiological characteristics of nasal colonization by S. aureus (MSSA-MRSA) in children from a university hospital and day care centers (DCCs) of Medellin, Colombia.MethodsAn observational cross-sectional study was conducted in 400 children (200 in each setting), aged 0 months to 5 years, during 2011. Samples were collected from each nostril and epidemiological information was obtained from the parents. Genotypic analysis included spa typing, PFGE, MLST, SCCmec typing, detection of genes for virulence factors and agr groups.ResultsFrequency of S. aureus colonization was 39.8% (n = 159) (hospital 44.5% and DCCs 35.0%) and by MRSA, 5.3% (n = 21) (hospital 7.0% and DCCs 3.5%). Most S. aureus colonized children were older than two years (p = 0.005), the majority of them boys (59.1%), shared a bedroom with a large number of people (p = 0.028), with history of β-Lactamase inhibitors usage (p = 0.020). MSSA strains presented the greatest genotypic diversity with 15 clonal complexes (CC). MRSA isolates presented 6 CC, most of them (47.6%) belonged to CC8-SCCmec IVc and were genetically related to previously reported infectious MRSA strains.ConclusionDifferences in epidemiological and molecular characteristics between populations may be useful for the understanding of S. aureus nasal colonization dynamics and for the design of strategies to prevent S. aureus infection and dissemination. The finding of colonizing MRSA with similar molecular characteristics of those causing infection demonstrates the dissemination capacity of S. aureus and the risk of infection among the child population.

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Section: Resultssupporting

confidence: 91%

Differences in Epidemiological and Molecular Characteristics of Nasal Colonization with Staphylococcus aureus (MSSA-MRSA) in Children from a University Hospital and Day Care Centers

et al. 2014

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“…The island-wide survey of S. aureus colonization among patients in pediatric ICUs showed that the S. aureus and MRSA nasal colonization rates were 26.3 and 17.5% in Taiwan, respectively. The MRSA nasal colonization rate in this study was relatively higher than that in pediatric ICU patients in the USA (4.5-6.0%) [26,27], Saudi Arabia (2.7%), or United Kingdom (1.6-2.9%) [28]. Firstly, the high colonization rate may be associated with the local MRSA epidemiology.…”

Section: Discussionmentioning

confidence: 52%

Prevalence and molecular characterizations of Staphylococcus aureus nasal colonization among patients in pediatric intensive care units in Taiwan

Chen

Huang

et al. 2020

Antimicrob Resist Infect Control

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Background: Nasal colonization of Staphylococcus aureus is a risk factor for the pathogen transmission and the development of infections. Limited information is available on the prevalence and molecular characteristics of S. aureus colonization in pediatric intensive care unit (ICU) patients. Methods: A cross-sectional, island-wide study was conducted in 2011. Nasal swabs were collected from pediatric ICU patients at six tertiary hospitals in Taiwan. Results: Of 114 patients enrolled in total, nasal colonization of S. arueus was detected in 30 (26.3%) of them, among whom 20 (17.5%) with methicillin-resistant S. arueus (MRSA). The ST59/SCCmec IV and V clones were most common and accounted for 45% of MRSA isolates, followed by ST239/SCCmec III (25%) and ST45/SCCmec IV (20%) clones. Three ST59 MRSA isolates carried the Panton-Valentine Leukocidin genes. Conclusions: The results indicated a high prevalence of S. arueus and MRSA nasal colonization among pediatric ICU patients in Taiwan. Identification of epidemic clones warrants the implement of infection control measures to reduce colonization and prevent the dissemination of MRSA in hospitals.

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“…42 This is not surprising and is associated with both the shorter exposure to the health care system and the smaller number of comorbidities in this population. 30,43 Even though the estimated burden of MRSA on admission to NICUs is relatively low, it is interesting given the young age of NICU patients and the sterile in utero environment. Transmission of MRSA through breast milk, 44,45 the birth canal, 36,46 and contact with family members has been described.…”

Section: Discussionmentioning

confidence: 99%

“…[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] The studies provided screening data on 19 722 neonatal and pediatric patients. More specifically, 11 studies reported data on 12 284 screened neonates in 12 NICUs, whereas 6 studies reported data on 7107 children hospitalized in 6 PICUs.…”

Section: Figurementioning

confidence: 99%

MRSA Colonization and Risk of Infection in the Neonatal and Pediatric ICU: A Meta-analysis

Zervou

Zacharioudakis

Ziakas³

et al. 2014

Pediatrics

110

102

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BACKGROUND AND OBJECTIVE: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality in NICUs and PICUs. Our objective was to assess the burden of MRSA colonization on admission, study the time trends, and examine the significance of MRSA colonization in this population. METHODS:PubMed and Embase databases were consulted. Studies that reported prevalence of MRSA colonization on ICU admission were selected. Two authors independently extracted data on MRSA colonization and infection. RESULTS:We identified 18 suitable articles and found an overall prevalence of MRSA colonization of 1.9% (95% confidence interval [CI] 1.3%-2.6%) on admission to the NICU or PICU, with a stable trend over the past 12 years. Interestingly, 5.8% (95% CI 1.9%-11.4%) of outborn neonates were colonized with MRSA on admission to NICU, compared with just 0.2% (95% CI 0.0%-0.9%) of inborn neonates (P = .01). The pooled acquisition rate of MRSA colonization was 4.1% (95% CI 1.2%-8.6%) during the NICU and PICU stay and was as high as 6.1% (95% CI 2.8%-10.6%) when the NICU population was studied alone. There was a relative risk of 24.2 (95% CI 8.9-66.0) for colonized patients to develop a MRSA infection during hospitalization. CONCLUSIONS:In the NICU and PICU, there are carriers of MRSA on admission, and MRSA colonization in the NICU is almost exclusively associated with outborn neonates. Importantly, despite infection control measures, the acquisition rate is high, and patients colonized with MRSA on admission are more likely to suffer a MRSA infection during hospitalization.

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Methicillin-resistant Staphylococcus aureus colonization in a pediatric intensive care unit: Risk factors

Cited by 19 publications

References 23 publications

Differences in Epidemiological and Molecular Characteristics of Nasal Colonization with Staphylococcus aureus (MSSA-MRSA) in Children from a University Hospital and Day Care Centers

Differences in Epidemiological and Molecular Characteristics of Nasal Colonization with Staphylococcus aureus (MSSA-MRSA) in Children from a University Hospital and Day Care Centers

Prevalence and molecular characterizations of Staphylococcus aureus nasal colonization among patients in pediatric intensive care units in Taiwan

MRSA Colonization and Risk of Infection in the Neonatal and Pediatric ICU: A Meta-analysis

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