Abstract
BackgroundIn the past decade methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly prevalent in community settings. Attending a daycare center (DCC) is a known risk factor for colonization with MRSA. Brazil operates free, public DCCs for low-income families, some of which are located in census tracts defined by the Brazilian Census Bureau as informal settlements (aglomerados subnormais, AGSN). Physical and demographic characteristics of AGSNs suggest that S. aureus colonization prevalence would be higher, but little is known about the prevalence of MRSA in these settings.MethodsWe conducted a cross-sectional study to assess risk factors for S. aureus and MRSA colonization among children attending DCCs located in AGSN vs non-AGSN. Nasal swabs were collected from children aged three months to six years in 23 public DCCs in Niterói, Brazil between August 2011 and October 2012.ResultsOf 500 children enrolled in the study, 240 (48%) were colonized with S. aureus and 31 (6.2%) were colonized with MRSA. Children attending DCCs in AGSNs were 2.32 times more likely to be colonized with S. aureus (95% CI: 1.32, 4.08), and 3.27 times more likely to be colonized with MRSA than children attending non-AGSN DCCs (95% CI: 1.52, 7.01), adjusted for confounding variables.ConclusionS. aureus and MRSA colonization prevalence among children attending DCCs in informal settlement census tracts was higher than previously reported in healthy pre-school children in Latin America. Our data suggest that transmission may occur more frequently in DCCs rather than at home, highlighting the importance of DCCs in AGSNs as potential MRSA reservoirs. This finding underscores the importance of local epidemiologic surveillance in vulnerable AGSN communities.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-538) contains supplementary material, which is available to authorized users.
Highlights
In the past decade methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly prevalent in community settings
Prevalence of nasal colonization for daycare center (DCC) located in non-aglomerado subnormal (AGSN) census tracts ranged from 0–10.5% for MRSA and 9% to 80.7% for S. aureus, while in AGSN DCCs, nasal colonization ranged from 0 to 21.4% for MRSA and 41.1 – 92.8% for S. aureus
Logistic regression indicated that when controlling for age, mother’s education, and the small increase in odds of colonization in those sampled later during the study period, children attending public DCCs in AGSN census tracts were 2.32 times more likely to be colonized with S. aureus than children attending DCCs outside of AGSNs (Table 3)
Summary
In the past decade methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly prevalent in community settings. Attending a daycare center (DCC) is a known risk factor for colonization with MRSA. In the throat, axilla, groin, perineum, and vagina, Staphylococcus aureus is the most commonly isolated bacterial pathogen in humans. It is responsible for a number of infections, ranging from uncomplicated skin and soft-tissue infections such as boils, carbuncles, and abscesses, to more severe invasive illnesses, including empyema, septic arthritis, pyomyositis, osteomyelitis, necrotizing fasciitis, pneumonia, endocarditis, and septicemia [1]. Increasing rates of cross-transmission between hospitals and communities have hampered the distinction between CA and HC acquired infections [5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
