Original ArticleMolecular Epidemiology of Staphylococcus aureus in Households of Children with Community-Associated S aureus Skin and Soft Tissue Infections
Section snippets
Methods
This study was approved by Washington University's Human Research Protection Office. Informed consent was obtained from index cases and their household contacts at study enrollment. Samples for the present study were obtained from a decolonization trial recently performed by our group that enrolled pediatric patients with CA SSTIs.15 This trial included patients (“index cases”) aged 6 months to 20 years who received care at St Louis Children's Hospital emergency department and ambulatory wound
Index Patient and Household Contact Characteristics
The 163 cases had a total of 562 household contacts enrolled in the study; the median household size was 4 persons (range, 2-12). The median age of the cases was 2.8 years (range, 0.5-20 years). Seventy index cases (44%) experienced an SSTI in the year before study enrollment (Table I). The median age of the 562 household contacts was 22.0 years (range, 0.1-88 years). Of the 562 household contacts, 112 (21%) reported an SSTI in the year before study enrollment (Table I).
Baseline Colonization and SSTIs
Of 163 index cases, 104
Discussion
S aureus colonization is a documented risk factor for subsequent infection.3, 6 In the present study, 67% of our pediatric patients were colonized at baseline with at least 1 strain that matched the infecting strain. The infecting strain from 55% of these index cases was concordant with the colonizing strain from at least 1 household contact, suggesting possible unique characteristics regarding virulence and the potential for transmission of certain strain types. A striking 33% of cases had
References (26)
- et al.
Skin infection in children colonized with community-associated methicillin-resistant Staphylococcus aureus
J Infect
(2009) - et al.
Molecular epidemiology and household transmission of community-associated methicillin-resistant Staphylococcus aureus in Hong Kong
Diagn Microbiol Infect Dis
(2007) Clinical practice: skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus
N Engl J Med
(2007)- et al.
Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children: executive summary
Clin Infect Dis
(2011) - et al.
Three-year surveillance of community-acquired Staphylococcus aureus infections in children
Clin Infect Dis
(2005) - et al.
Involvement of Panton-Valentine leukocidin–producing Staphylococcus aureus in primary skin infections and pneumonia
Clin Infect Dis
(1999) - et al.
Natural history of community-acquired methicillin-resistant Staphylococcus aureus colonization and infection in soldiers
Clin Infect Dis
(2004) - et al.
Nasal carriage as a source of Staphylococcus aureus bacteremia
N Engl J Med
(2001) - et al.
Discordance between Staphylococcus aureus nasal colonization and skin infections in children
Pediatr Infect Dis J
(2009) - et al.
Family outbreaks of invasive community-associated methicillin-resistant Staphylococcus aureus infection
Clin Infect Dis
(2006)
Nasal carriage of methicillin-resistant Staphylococcus aureus in household contacts of children with community-acquired diseases in Taiwan
Pediatr Infect Dis J
Multiple cases of familial transmission of community-acquired methicillin-resistant Staphylococcus aureus
J Clin Microbiol
High prevalence of MRSA in household contacts
Scand J Infect Dis
Cited by (0)
Supported by the Infectious Diseases Society of America/National Foundation for Infectious Diseases Pfizer Fellowship in Clinical Disease (to S.F.), the National Institutes of Health (UL1-RR024992, KL2RR024994, and K23-AI091690 to S.F.), the Agency for Healthcare Research and Quality (R01-HS021736 to S.F.), and the Children's Discovery Institute of Washington University and St. Louis Children's Hospital (to S.F.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Agency for Healthcare Research and Quality. The authors declare no conflicts of interest.
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Present affiliation: Southern Illinois University, Springfield, IL.