Prevalence of and risk factors for community-acquired methicillin-resistant and methicillin-sensitive Staphylococcus aureus colonization in children seen in a practice-based research network
Prevalence of and risk factors for community-acquired methicillin-resistant and methicillin-sensitive Staphylococcus aureus colonization in children seen in a practice-based research network
复制标题
DOI：
10.1542/peds.2007-2104
复制
发表时间：
2008-06-01
期刊：
影响因子：
8
通讯作者：
Storch, Gregory A.
中科院分区：
文献类型：
--
作者：
Fritz, Stephanie A.;Garbutt, Jane;Storch, Gregory A.
OBJECTIVE.我们试图确定圣刘易斯儿童人群中耐甲氧西林金黄色葡萄球菌鼻腔定植的患病率和危险因素。从出生到18岁的儿童提出的生病和良好的访问是从儿科实践隶属于实践为基础的研究网络招募。获得鼻拭子，并进行问卷调查。我们从11个实践中招募了1300名参与者。耐甲氧西林金黄色葡萄球菌鼻腔定植的患病率根据实践而变化，从0%到9%（平均值：2.6%）。圣刘易斯大都市区2个主要县的耐甲氧西林金黄色葡萄球菌鼻腔定植的估计人群患病率为2.4%。在32株耐甲氧西林金黄色葡萄球菌分离株中，9株（28%）为医疗保健相关型，21株（66%）为社区获得型。与卫生保健相关的耐甲氧西林金黄色葡萄球菌定植的儿童相比，社区获得耐甲氧西林金黄色葡萄球菌的儿童中有显着更多的是黑人，并参加了医疗补助。与没有定植的儿童相比，两种类型的耐甲氧西林金黄色葡萄球菌定植的儿童与卫生保健的接触增加。甲氧西林敏感的金黄色葡萄球菌鼻腔定植范围从9%至31%的做法（平均值：24%）。甲氧西林敏感金黄色葡萄球菌的估计人群患病率为24.6%。与甲氧西林敏感金黄色葡萄球菌定植相关的危险因素包括养宠物、咬指甲和参加体育活动。耐甲氧西林金黄色葡萄球菌定植在我们社区的儿童中广泛存在，包括与卫生保健相关和社区获得性感染相关的菌株。
OBJECTIVE. We sought to define the prevalence of and risk factors for methicillin-resistant Staphylococcus aureus nasal colonization in the St Louis pediatric population.METHODS. Children from birth to 18 years of age presenting for sick and well visits were recruited from pediatric practices affiliated with a practice-based research network. Nasal swabs were obtained, and a questionnaire was administered.RESULTS. We enrolled 1300 participants from 11 practices. The prevalence of methicillin-resistant S aureus nasal colonization varied according to practice, from 0% to 9% (mean: 2.6%). The estimated population prevalence of methicillin-resistant S aureus nasal colonization for the 2 main counties of the St Louis metropolitan area was 2.4%. Of the 32 methicillin-resistant S aureus isolates, 9 (28%) were health care-associated types and 21 (66%) were community-acquired types. A significantly greater number of children with community-acquired methicillin-resistant S aureus were black and were enrolled in Medicaid, in comparison with children colonized with health care-associated methicillin-resistant S aureus. Children with both types of methicillin-resistant S aureus colonization had increased contact with health care, compared with children without colonization. Methicillin-sensitive S aureus nasal colonization ranged from 9% to 31% among practices (mean: 24%). The estimated population prevalence of methicillin-sensitive S aureus was 24.6%. Risk factors associated with methicillin-sensitive S aureus colonization included pet ownership, fingernail biting, and sports participation.CONCLUSIONS. Methicillin-resistant S aureus colonization is widespread among children in our community and includes strains associated with health care-associated and community-acquired infections.