TY - JOUR
T1 - Skin infection in children colonized with community-associated methicillin-resistant Staphylococcus aureus
AU - Fritz, Stephanie A.
AU - Epplin, Emma K.
AU - Garbutt, Jane
AU - Storch, Gregory A.
N1 - Funding Information:
This research was supported by the National Institutes of Health under Ruth L. Kirschstein National Research Service Award 5T32 HD007507 from the National Institute of Child Health and Human Development. In addition, this publication was made possible by Grant Number UL1 RR024992 and K30 RR022251 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.
PY - 2009/12
Y1 - 2009/12
N2 - Objectives: The relationship between community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) nasal colonization and subsequent infection in children is unknown. We sought to define risk factors for skin and soft tissue infection (SSTI) in community children. Methods: A prior study measured S. aureus nasal colonization prevalence for 1300 community children. To detect subsequent SSTI in these children or a household member, surveys were administered 6 and 12 months following enrollment. Results: SSTIs were reported by 56/708 (8.1%) respondents during the initial 6-month interval. SSTI developed in 6/26 (23%) initially colonized with MRSA, 16/194 (8%) with methicillin-sensitive S. aureus colonization, and 34/474 (7%) not colonized with S. aureus (MRSA vs. not MRSA, univariate analysis, p = 0.014). In multivariable analysis, factors associated with SSTI included history of SSTI in the child during the year preceding enrollment (p < 0.01) and SSTI in household contacts during the follow-up interval (p < 0.01); MRSA nasal colonization approached statistical significance (p = 0.08). Conclusions: In the current era of community MRSA transmission, SSTI is a disease of households, with recurrences in index cases and occurrences among household contacts. Children with MRSA colonization may be at risk for subsequent SSTI. Further study of MRSA transmission dynamics in households and preventive strategies should receive high priority.
AB - Objectives: The relationship between community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) nasal colonization and subsequent infection in children is unknown. We sought to define risk factors for skin and soft tissue infection (SSTI) in community children. Methods: A prior study measured S. aureus nasal colonization prevalence for 1300 community children. To detect subsequent SSTI in these children or a household member, surveys were administered 6 and 12 months following enrollment. Results: SSTIs were reported by 56/708 (8.1%) respondents during the initial 6-month interval. SSTI developed in 6/26 (23%) initially colonized with MRSA, 16/194 (8%) with methicillin-sensitive S. aureus colonization, and 34/474 (7%) not colonized with S. aureus (MRSA vs. not MRSA, univariate analysis, p = 0.014). In multivariable analysis, factors associated with SSTI included history of SSTI in the child during the year preceding enrollment (p < 0.01) and SSTI in household contacts during the follow-up interval (p < 0.01); MRSA nasal colonization approached statistical significance (p = 0.08). Conclusions: In the current era of community MRSA transmission, SSTI is a disease of households, with recurrences in index cases and occurrences among household contacts. Children with MRSA colonization may be at risk for subsequent SSTI. Further study of MRSA transmission dynamics in households and preventive strategies should receive high priority.
KW - Community-associated Staphylococcus aureus
KW - Methicillin resistance
KW - Practice-based research network
KW - Skin and soft tissue infection
UR - http://www.scopus.com/inward/record.url?scp=71849108982&partnerID=8YFLogxK
U2 - 10.1016/j.jinf.2009.09.001
DO - 10.1016/j.jinf.2009.09.001
M3 - Article
C2 - 19747505
AN - SCOPUS:71849108982
SN - 0163-4453
VL - 59
SP - 394
EP - 401
JO - Journal of Infection
JF - Journal of Infection
IS - 6
ER -