Abstract
Background: Staphylococcus aureus (S. aureus) is a major pathogen of human infections. Its fecal carriage serves as a risk factor for nosocomial transmission and disease development. However, the rate of S. aureus fecal carriage among Chinese children has not yet been reported. Therefore, we sought to investigate the prevalence, characterization, and drug resistance of S. aureus isolated from pediatric patients' feces in Southern China.Methods: Fecal samples (2059) from pediatric patients in three centers in Guangzhou were cultured. From which, 412 S. aureus isolates were identified via selective mediums and automated VITEK Mass Spectrometer analysis. Antibiotic susceptibility was determined and DNA sequencing of seven housekeeping genes were used for multilocus sequence typing analysis.Results: The fecal carriage rates were 20.0% for S. aureus and 4.5% for methicillin-resistant S. aureus (MRSA). Moreover, S. aureus fecal carriage was positively correlated with outpatient status and gastroenteritis diagnosis. Moreover, age-related patterns were observed with respect to prevalence of S. aureus. Besides, a total of 76 sequence types (STs) were identified, including 25 newly assigned STs and 28 clonal complexes (CCs). ST188, ST6, and ST15 were the most prevalent methicillin-sensitive S. aureus (MSSA) clones, while ST59 and ST45 were the major MRSA clones. S. aureus isolates also exhibited high rates of penicillin (84.2%), erythromycin (38.8%), and clindamycin (35.9%) resistance. Specifically, all ST30 and ST338 isolates were resistant to erythromycin and clindamycin, 61% of ST7 were resistant to tetracycline, and 84% of ST45 exhibited resistance and intermediate resistance to rifampicin. Also, CC59 (ST338 and ST59) and CC45 exhibited different antibiotic resistance patterns.Conclusion: These results demonstrate the colonization dynamics and molecular epidemiology of S. aureus in child feces in Southern China. Further, they suggest an urgency for strengthening the surveillance programs in China and provide important information for the prevention and treatment of S. aureus infection.
Highlights
Staphylococcus aureus (S. aureus) is a major pathogen of human infection that causes diseases ranging from minor skin infections to severe bacteremia, necrotizing pneumonia, and lifethreatening sepsis [1,2,3], and is a major global threat to human health
S. aureus fecal carriage may contribute to environmental contamination [12], which can lead to nosocomial transmission and infection
Previous studies have reported fecal carriage of S. aureus in adults from Nigeria [13] and India [14], and a recent study investigated intestinal colonization by S. aureus and Clostridium difficile in healthy adult fecal samples from China [15], and a few studies have reported on S. aureus isolated from pediatric patients’ feces samples in China
Summary
Staphylococcus aureus (S. aureus) is a major pathogen of human infection that causes diseases ranging from minor skin infections to severe bacteremia, necrotizing pneumonia, and lifethreatening sepsis [1,2,3], and is a major global threat to human health. Colonization is a crucial risk factor for the subsequent development of infections [8]. The importance of S. aureus fecal colonization was described as early as 1960 [9], in a study that demonstrated rectal carriage of S. aureus earlier than from the nose or throat. Previous studies have reported fecal carriage of S. aureus in adults from Nigeria [13] and India [14], and a recent study investigated intestinal colonization by S. aureus and Clostridium difficile in healthy adult fecal samples from China [15], and a few studies have reported on S. aureus isolated from pediatric patients’ feces samples in China. Its fecal carriage serves as a risk factor for nosocomial transmission and disease development. We sought to investigate the prevalence, characterization, and drug resistance of S. aureus isolated from pediatric patients’ feces in Southern China
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