Prevalence of community-acquired methicillin-resistant staphylococcus aureus nasal colonization among children

Veena Shetty, Katherine Trumbull, Amitha Hegde, Vijaya Shenoy, Raghavendra Prabhu, K. Sumathi, Elizabeth Palavecino, Avinash K. Shetty

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Conclusion: Children in India have a high rate of nasal colonization of S. aureus. Nasal colonization of community-associated methicillin-resistant S. aureus exists but is still low among healthy children. The high rate of resistance to many classes of antibiotics among S. aureus strains is of great concern warranting continued surveillance and antimicrobial stewardship.

Background: Invasive infections from community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are increasingly being encountered in healthy children. Nasal colonization of MRSA is associated with increased risk for acquiring invasive disease. The objective of this study was to determine prevalence and risk factors for CA-MRSA nasal colonization among a healthy paediatric population and to determine antibiotic susceptibilities of S. aureus isolates.

Materials and Methods: Using a cross-sectional study design, children aged 1mnth-17y attending well-child clinic at an academic hospital and a local public school in Mangalore, India were screened for S. aureus colonization via nasal swabs. A questionnaire was administered and data on risk factors for nasal colonization was collected. Samples were obtained from the anterior nares and cultured quantitatively. S. aureus isolates were confirmed by growth on selective media and coagulase testing. Disk diffusion antibiotic susceptibility tests were performed according to Clinical and Laboratory Standard Institute guidelines.

Results: Of the 500 children included in the study, S. aureus was isolated from the anterior nares in 126 (25%) children; 4 (3%) isolates were classified as CA-MRSA. Factors associated with S. aureus nasal colonization were children <6 y old (p=0.030) and members of joint families (p=0.044). Resistance to many classes of antibiotics were noted among S. aureus isolates including trimethoprim-sulfamethoxazole (39%), ciprofloxacin (16%), erythromycin (19%) and clindamycin (5%). Inducible clindamycin resistance (positive D test) was detected in 11 of the erythromycin-resistant strains not already classified as resistant to clindamycin. No resistance to vancomycin was observed.

Original languageEnglish
Pages (from-to)DC12-DC15
JournalJournal of Clinical and Diagnostic Research
Volume8
Issue number12
DOIs
Publication statusPublished - 05-12-2014
Externally publishedYes

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Methicillin
Methicillin-Resistant Staphylococcus aureus
Nose
Clindamycin
Staphylococcus aureus
Anti-Bacterial Agents
Erythromycin
Pediatrics
Coagulase
Sulfamethoxazole Drug Combination Trimethoprim
Vancomycin
Ciprofloxacin
India
Vancomycin Resistance
Community-Acquired Infections
Testing
Cross-Sectional Studies
Joints
Guidelines
Growth

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry

Cite this

Shetty, Veena ; Trumbull, Katherine ; Hegde, Amitha ; Shenoy, Vijaya ; Prabhu, Raghavendra ; Sumathi, K. ; Palavecino, Elizabeth ; Shetty, Avinash K. / Prevalence of community-acquired methicillin-resistant staphylococcus aureus nasal colonization among children. In: Journal of Clinical and Diagnostic Research. 2014 ; Vol. 8, No. 12. pp. DC12-DC15.
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title = "Prevalence of community-acquired methicillin-resistant staphylococcus aureus nasal colonization among children",
abstract = "Conclusion: Children in India have a high rate of nasal colonization of S. aureus. Nasal colonization of community-associated methicillin-resistant S. aureus exists but is still low among healthy children. The high rate of resistance to many classes of antibiotics among S. aureus strains is of great concern warranting continued surveillance and antimicrobial stewardship.Background: Invasive infections from community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are increasingly being encountered in healthy children. Nasal colonization of MRSA is associated with increased risk for acquiring invasive disease. The objective of this study was to determine prevalence and risk factors for CA-MRSA nasal colonization among a healthy paediatric population and to determine antibiotic susceptibilities of S. aureus isolates.Materials and Methods: Using a cross-sectional study design, children aged 1mnth-17y attending well-child clinic at an academic hospital and a local public school in Mangalore, India were screened for S. aureus colonization via nasal swabs. A questionnaire was administered and data on risk factors for nasal colonization was collected. Samples were obtained from the anterior nares and cultured quantitatively. S. aureus isolates were confirmed by growth on selective media and coagulase testing. Disk diffusion antibiotic susceptibility tests were performed according to Clinical and Laboratory Standard Institute guidelines.Results: Of the 500 children included in the study, S. aureus was isolated from the anterior nares in 126 (25{\%}) children; 4 (3{\%}) isolates were classified as CA-MRSA. Factors associated with S. aureus nasal colonization were children <6 y old (p=0.030) and members of joint families (p=0.044). Resistance to many classes of antibiotics were noted among S. aureus isolates including trimethoprim-sulfamethoxazole (39{\%}), ciprofloxacin (16{\%}), erythromycin (19{\%}) and clindamycin (5{\%}). Inducible clindamycin resistance (positive D test) was detected in 11 of the erythromycin-resistant strains not already classified as resistant to clindamycin. No resistance to vancomycin was observed.",
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Shetty, V, Trumbull, K, Hegde, A, Shenoy, V, Prabhu, R, Sumathi, K, Palavecino, E & Shetty, AK 2014, 'Prevalence of community-acquired methicillin-resistant staphylococcus aureus nasal colonization among children', Journal of Clinical and Diagnostic Research, vol. 8, no. 12, pp. DC12-DC15. https://doi.org/10.7860/JCDR/2014/9986.5276

Prevalence of community-acquired methicillin-resistant staphylococcus aureus nasal colonization among children. / Shetty, Veena; Trumbull, Katherine; Hegde, Amitha; Shenoy, Vijaya; Prabhu, Raghavendra; Sumathi, K.; Palavecino, Elizabeth; Shetty, Avinash K.

In: Journal of Clinical and Diagnostic Research, Vol. 8, No. 12, 05.12.2014, p. DC12-DC15.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prevalence of community-acquired methicillin-resistant staphylococcus aureus nasal colonization among children

AU - Shetty, Veena

AU - Trumbull, Katherine

AU - Hegde, Amitha

AU - Shenoy, Vijaya

AU - Prabhu, Raghavendra

AU - Sumathi, K.

AU - Palavecino, Elizabeth

AU - Shetty, Avinash K.

PY - 2014/12/5

Y1 - 2014/12/5

N2 - Conclusion: Children in India have a high rate of nasal colonization of S. aureus. Nasal colonization of community-associated methicillin-resistant S. aureus exists but is still low among healthy children. The high rate of resistance to many classes of antibiotics among S. aureus strains is of great concern warranting continued surveillance and antimicrobial stewardship.Background: Invasive infections from community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are increasingly being encountered in healthy children. Nasal colonization of MRSA is associated with increased risk for acquiring invasive disease. The objective of this study was to determine prevalence and risk factors for CA-MRSA nasal colonization among a healthy paediatric population and to determine antibiotic susceptibilities of S. aureus isolates.Materials and Methods: Using a cross-sectional study design, children aged 1mnth-17y attending well-child clinic at an academic hospital and a local public school in Mangalore, India were screened for S. aureus colonization via nasal swabs. A questionnaire was administered and data on risk factors for nasal colonization was collected. Samples were obtained from the anterior nares and cultured quantitatively. S. aureus isolates were confirmed by growth on selective media and coagulase testing. Disk diffusion antibiotic susceptibility tests were performed according to Clinical and Laboratory Standard Institute guidelines.Results: Of the 500 children included in the study, S. aureus was isolated from the anterior nares in 126 (25%) children; 4 (3%) isolates were classified as CA-MRSA. Factors associated with S. aureus nasal colonization were children <6 y old (p=0.030) and members of joint families (p=0.044). Resistance to many classes of antibiotics were noted among S. aureus isolates including trimethoprim-sulfamethoxazole (39%), ciprofloxacin (16%), erythromycin (19%) and clindamycin (5%). Inducible clindamycin resistance (positive D test) was detected in 11 of the erythromycin-resistant strains not already classified as resistant to clindamycin. No resistance to vancomycin was observed.

AB - Conclusion: Children in India have a high rate of nasal colonization of S. aureus. Nasal colonization of community-associated methicillin-resistant S. aureus exists but is still low among healthy children. The high rate of resistance to many classes of antibiotics among S. aureus strains is of great concern warranting continued surveillance and antimicrobial stewardship.Background: Invasive infections from community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are increasingly being encountered in healthy children. Nasal colonization of MRSA is associated with increased risk for acquiring invasive disease. The objective of this study was to determine prevalence and risk factors for CA-MRSA nasal colonization among a healthy paediatric population and to determine antibiotic susceptibilities of S. aureus isolates.Materials and Methods: Using a cross-sectional study design, children aged 1mnth-17y attending well-child clinic at an academic hospital and a local public school in Mangalore, India were screened for S. aureus colonization via nasal swabs. A questionnaire was administered and data on risk factors for nasal colonization was collected. Samples were obtained from the anterior nares and cultured quantitatively. S. aureus isolates were confirmed by growth on selective media and coagulase testing. Disk diffusion antibiotic susceptibility tests were performed according to Clinical and Laboratory Standard Institute guidelines.Results: Of the 500 children included in the study, S. aureus was isolated from the anterior nares in 126 (25%) children; 4 (3%) isolates were classified as CA-MRSA. Factors associated with S. aureus nasal colonization were children <6 y old (p=0.030) and members of joint families (p=0.044). Resistance to many classes of antibiotics were noted among S. aureus isolates including trimethoprim-sulfamethoxazole (39%), ciprofloxacin (16%), erythromycin (19%) and clindamycin (5%). Inducible clindamycin resistance (positive D test) was detected in 11 of the erythromycin-resistant strains not already classified as resistant to clindamycin. No resistance to vancomycin was observed.

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