Abstract

BackgroundWe describe methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage at admission in patients admitted to a Department of Pediatrics.MethodsAll patients received a nasal swab at admission. A questionnaire was administered and molecular genetics analyses were performed on all identified MRSA isolates.ResultsWe enrolled 785 patients, affected with both acute and chronic diseases. MRSA nasal colonization prevalence was 1.15% (CI: 0.5607%-2.093%). Methicillin-sensitive Staphylococcus aureus (MSSA) nasal colonization prevalence at admission was 19.75% (CI 17.07%-22.64%). Only one MRSA isolate carried the SCCmec V variant; all other isolates carried the SCCmecIV variant. Five out of 9 MRSA-colonized patients had an underlying condition. Antibiotic therapy in the previous 6 months was a protective factor for both MRSA (OR 0,66; 95% CI: 0,46-0,96) and MSSA (OR 0,65; 95% CI: 0,45-0,97) colonization. A tendency to statistical significance was seen in the association between hospitalization in the 6 months prior to admission and MRSA colonization at admission (OR 4,92; 95% CI: 0,97-24,83). No patient was diagnosed with an S. aureus infection during hospitalization.ConclusionsThe majority of our MRSA colonizing isolates have community origins. Nevertheless, most MRSA-colonized patients had been hospitalized previously, suggesting that strains that circulate in the community also circulate in hospital settings. Further studies should elucidate the role of children with frequent contact with health care institutions in the circulation of antibiotic resistant strains between the hospital and the community.

Highlights

  • We describe methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage at admission in patients admitted to a Department of Pediatrics

  • Most of the surveys that investigated nasal carriage have been conducted on healthy pediatric populations, or on patients admitted to Intensive Care Units [7]

  • The objectives of the present study were to assess the prevalence of Methicillin-sensitive Staphylococcus aureus (MSSA) and MRSA nasal colonization among patients admitted to a pediatric department, to describe molecular genetic characteristics of the colonizing isolates, and to identify epidemiological risk factors associated with MSSA and MRSA nasal colonization

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Summary

Introduction

We describe methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage at admission in patients admitted to a Department of Pediatrics. After an increasing trend in the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections in Europe and the United States, both in adults and in children [1,2], encouraging data on a general reduction of invasive MRSA infections have been recently reported [3,4]. The proportion of S. aureus isolates identified as methicillin-resistant is stabilizing or decreasing in most European countries [5]. Most of the surveys that investigated nasal carriage have been conducted on healthy pediatric populations, or on patients admitted to Intensive Care Units [7]. Few studies have investigated nasal carriage in General Pediatric Wards [8]

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