TY - JOUR
T1 - Interplay of personal, pet, and environmental colonization in households affected by community-associated methicillin-resistant Staphylococcus aureus
AU - Hogan, Patrick G.
AU - Mork, Ryan L.
AU - Boyle, Mary G.
AU - Muenks, Carol E.
AU - Morelli, John J.
AU - Thompson, Ryley M.
AU - Sullivan, Melanie L.
AU - Gehlert, Sarah J.
AU - Merlo, Jessica R.
AU - McKenzie, Matt G.
AU - Wardenburg, Juliane Bubeck
AU - Rzhetsky, Andrey
AU - Burnham, Carey Ann D.
AU - Fritz, Stephanie A.
N1 - Funding Information:
This work was supported by the Children's Discovery Institute of Washington University and St. Louis Children's Hospital; National Institutes of Health (NIH)/National Institute of Allergy and Infectious Diseases [grant number K23-AI091690 to S.A.F.]; NIH/National Center for Advancing Translational Sciences [grant number UL1-TR002345 to S.A.F.]; the Agency for Healthcare Research and Quality (AHRQ) [grant numbers R01-HS021736 , R01-HS024269 to S.A.F.]; and the Burroughs Wellcome Foundation Investigators in the Pathogenesis of Infectious Disease Award [to J.B.W.]. The computational analysis was partially funded by Defense Advanced Research Projects Agency Big Mechanism program under ARO contract W911NF1410333 [to A.R.]; NIH grants R01HL122712 , 1P50MH094267 , U01HL108634 [to A.R.]; and a gift from Liz and Kent Dauten [to A.R.]. These funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or AHRQ.
Publisher Copyright:
© 2018
PY - 2019/3
Y1 - 2019/3
N2 - Objective: We sought to determine the prevalence, molecular epidemiology, and factors associated with Staphylococcus aureus environmental surface and pet colonization in households of children with community-associated methicillin-resistant S. aureus (CA–MRSA) infection. Methods: Between 2012 and 2015, 150 children with CA–MRSA infections and their household contacts and pets were enrolled in this cross-sectional study in metropolitan Saint Louis, MO. Cultures to detect S. aureus were collected from 3 anatomic sites of household members, 2 dog/cat sites, and 21 environmental surfaces in each household. Molecular epidemiology of S. aureus isolates was determined via repetitive-sequence PCR. Generalized linear models were developed to identify factors associated with S. aureus/MRSA household contamination. Results: MRSA was recovered from environmental surfaces in 69 (46%) households (median 2 surfaces [range 1–18]). The enrollment infecting strain type was the most common strain recovered from the environment in most (64%) households. In generalized linear models, factors associated with a higher proportion of MRSA-contaminated environmental surfaces were household member MRSA colonization burden, MRSA as the dominant S. aureus strain colonizing household members, more strain types per household member, index case African–American race, and renting (vs. owning) the home. Of 132 pets, 14% were colonized with MRSA. Pets whose primary caretaker was MRSA-colonized were more likely to be MRSA-colonized than pets whose primary caretaker was not MRSA-colonized (50% vs. 4%, p < 0.001). Conclusions: Household environments and pet dogs and cats serve as reservoirs of MRSA. Household member MRSA colonization burden predicts environmental MRSA contamination. Longitudinal studies will inform the directionality of household transmission.
AB - Objective: We sought to determine the prevalence, molecular epidemiology, and factors associated with Staphylococcus aureus environmental surface and pet colonization in households of children with community-associated methicillin-resistant S. aureus (CA–MRSA) infection. Methods: Between 2012 and 2015, 150 children with CA–MRSA infections and their household contacts and pets were enrolled in this cross-sectional study in metropolitan Saint Louis, MO. Cultures to detect S. aureus were collected from 3 anatomic sites of household members, 2 dog/cat sites, and 21 environmental surfaces in each household. Molecular epidemiology of S. aureus isolates was determined via repetitive-sequence PCR. Generalized linear models were developed to identify factors associated with S. aureus/MRSA household contamination. Results: MRSA was recovered from environmental surfaces in 69 (46%) households (median 2 surfaces [range 1–18]). The enrollment infecting strain type was the most common strain recovered from the environment in most (64%) households. In generalized linear models, factors associated with a higher proportion of MRSA-contaminated environmental surfaces were household member MRSA colonization burden, MRSA as the dominant S. aureus strain colonizing household members, more strain types per household member, index case African–American race, and renting (vs. owning) the home. Of 132 pets, 14% were colonized with MRSA. Pets whose primary caretaker was MRSA-colonized were more likely to be MRSA-colonized than pets whose primary caretaker was not MRSA-colonized (50% vs. 4%, p < 0.001). Conclusions: Household environments and pet dogs and cats serve as reservoirs of MRSA. Household member MRSA colonization burden predicts environmental MRSA contamination. Longitudinal studies will inform the directionality of household transmission.
KW - Community-associated methicillin-resistant Staphylococcus aureus
KW - Environmental contamination
KW - Household reservoirs
KW - Pets
UR - http://www.scopus.com/inward/record.url?scp=85057593895&partnerID=8YFLogxK
U2 - 10.1016/j.jinf.2018.11.006
DO - 10.1016/j.jinf.2018.11.006
M3 - Article
C2 - 30503843
AN - SCOPUS:85057593895
SN - 0163-4453
VL - 78
SP - 200
EP - 207
JO - Journal of Infection
JF - Journal of Infection
IS - 3
ER -