Abstract
Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization in infants may pose a risk for subsequent infection in children. The study aimed to determine S. aureus colonization patterns in infancy, and strain relatedness between maternal and infant colonization.Methods: A prospective cohort study was conducted for nasopharyngeal S. aureus detection in neonates at delivery; in children at 1, 6, 12, 24, 36, and 60 months of age; and from mothers immediately after the delivery of their baby and when their child is 1 month old. A questionnaire for infants and mothers was administered at each planned visit.Results: In total, 521 and 135 infant–mother dyads underwent nasopharyngeal swab collection at 1 month and immediately after delivery, respectively. Among the 521 dyads at 1 month of age, concordant S. aureus colonization was found in 95 dyads, including MRSA in 48.4% (46/95). No concordant MRSA carriage was present among the 135 dyads at delivery. The genetic relatedness of concurrent MRSA-colonized dyads showed that more than two-thirds (32/46 [69.6%]) had identical genotypes, mainly ST 59/PVL-negative/SCCmec IV. Infants aged 1 month had the highest incidence of S. aureus, and the trend declined to a nadir at the age of 12 months. Carrier mothers who smoked cigarettes may increase the risk of infant Staphylococcus colonization (odds ratio, 2.12; 95% confidence interval, 1.23–3.66; p < 0.01).Conclusions: Maternal–infant horizontal transmission may be the primary source of MRSA acquisition in early infancy. The avoidance of passive smoking could be recommended for the prevention of S. aureus carriage.
Highlights
Staphylococcus aureus is a major cause of infectious diseases ranging from soft-tissue infections to bacteraemia, which causes substantial morbidity or mortality in hospital settings and communities [1, 2]
Questionnaire-based surveys and nasopharyngeal swabs were received from 630 infants and 536 mothers one month past delivery
Infants aged 1 month had the highest incidence of S. aureus and Methicillin-resistant S. aureus (MRSA) carriage, and the trend declined to a nadir at the age of 12 months
Summary
Staphylococcus aureus is a major cause of infectious diseases ranging from soft-tissue infections to bacteraemia, which causes substantial morbidity or mortality in hospital settings and communities [1, 2]. The prevalence of infections caused by MRSA has increased among healthy people, among children without established risk factors for MRSA acquisition [4], namely, community-associated MRSA (CA-MRSA). Chen et al [4] showed that MRSA has accounted for 50% of childhood community-associated S. aureus infections in Taiwan since 2005. In the United States, hospitalized infants under 1 yr of age had the highest risk of Staphylococcus infection, highest annual incidence, and highest mortality among children under 17 yr of age [6]. A high incidence of childhood CA-MRSA infection has occurred in the past decade, the cause of this increase is not well understood. Methicillin-resistant Staphylococcus aureus (MRSA) colonization in infants may pose a risk for subsequent infection in children. The study aimed to determine S. aureus colonization patterns in infancy, and strain relatedness between maternal and infant colonization
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