Original Article

Frequency of methicillin-resistant Staphylococcus aureus nasal carriage in healthy children

Abstract

Background and Objective: The prevalence of community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) is increasing around the world. It involves healthy people and causes a variety of diseases.
Material and Methods: This cross sectional study was conducted from September 2010 - June 2011 on children less than 14 years of Ahvaz, southwest Iran. The participants were selected with two staged cluster sampling. A sterile cotton nasal swab was used to collect the samples from the 864 participants. MRSA isolates were identifed by catalase and coagulase tests and 1 μg oxacillin disk method. Polymerase chain reaction (PCR) was performed on all the MRSA colonies to detect the mecA gene. Data was put in SPSS 16 software and descriptive statistics and chi-square test were used for analysis.
Results: Out of 864 children, 471(54.51%) were male and 393 (45.49%) were female. 235 children (27.1%) had Staphylococcus aureus and 11 (1.3%) of all children diagnosed with MRSA. PCR showed that 7 colonies (0.8%) had the mecA gene.
Conclusion: The results of this study indicate that MRSA exists in healthy children of Ahvaz. Although the prevalence of CA-MRSA is lower than many other regions, it still needs close attention to prevent its transmission. Further studies are needed to identify the risk factors of CA-MRSA.

Lee BY, Singh A, David MZ, Bartsch SM, Slayton RB, Huang SS, et al. The economic burden of communi- ty-associated methicillin-resistant Staphylococcus au- reus (CA-MRSA). Clin Microbiol Infect 2012; 19:528-536.

Mithoe D, Rijnders MI, Roede BM, Stobberingh E, Moller AV. Prevalence of community-associated meticillin-resistant Staphylococcus aureus and Pan- ton-Valentine leucocidin-positive S. aureus in general practice patients with skin and soft tissue infections in the northern and southern regions of The Netherlands. Eur J Clin Microbiol Infect Dis 2012; 31:349-356.

Nakamura MM, Rohling KL, Shashaty M, Lu H, Tang YW, Edwards KM. Prevalence of methicillin-resistant Staphylococcus aureus nasal carriage in the commu-nity pediatric population. Pediatr Infect Dis J 2002;21:917-922.

Huang YC, Hwang KP, Chen PY, Chen CJ, Lin TY.Prevalence of methicillin-resistant Staphylococcus au- reus nasal colonization among Taiwanese children in 2005 and 2006. J Clin Microbiol 2007; 45: 3992-3995.

Gonzalez BE, Hulten KG, Dishop MK, Lamberth LB, Hammerman WA, Mason EO Jr, et al. Pulmonary manifestations in children with invasive communi- ty-acquired Staphylococcus aureus infection. Clin In- fect Dis 2005; 41:583-590.

Gonzalez BE, Martinez-Aguilar G, Hulten KG, Ham- merman WA, Coss-Bu J, Avalos-Mishaan, et al. Se- vere Staphylococcal sepsis in adolescents in the era of community-acquired methicillin-resistant Staphylo- coccus aureus. Pediatrics 2005; 115:642-648.

Zhao C, Liu Y, Zhao M, Yu Y, Chen H, Sun Q, et al.

Characterization of community acquired Staphylo- coccus aureus associated with skin and soft tissue in- fection in Beijing: High prevalence of PVL(+) ST398. PLoS One 2012; 7:e38577.

Walraven CJ, Lingenfelter E, Rollo J, Madsen T, Al- exander DP. Diagnostic and therapeutic evaluation of community-acquired methicillin-resistant Staphylo- coccus aureus (MRSA) skin and soft tissue infections in the emergency department. J Emerg Med 2012;42:392-399.

Damasco PV, Chamon RC, Barbosa AT, da Cunha S, Aquino JH, Cavalcante FS, et al. Involvement of meth- icillin-susceptible Staphylococcus aureus related to sequence type 25 and harboring pvl genes in a case of carotid cavernous fistula after community-associated sepsis. J Clin Microbiol 2012;50: 196-198.

Milstone AM, Carroll KC, Ross T, Shangraw KA, Perl TM. Community-associated methicillin-resistant Staphylococcus aureus strains in pediatric intensive care unit. Emerg Infect Dis 2010; 16:647-655.

Daum RS. Community-acquired methicillin-resistant Staphylococcus aureus infections. Pediatr Infect Dis J 1998; 17:745-746.

Shahraz F, Dadkhah H, Khaksar R, Mahmoudzadeh M, Hosseini H, Kamran M, et al. Analysis of antibi- otic resistance patterns and detection of mecA gene in Staphylococcus aureus isolated from packaged ham- burger. Meat Sci 2012; 90:759-763.

Von Eiff C, Becker K, Machka K, Stammer H, Peters G. Nasal carriage as a source of Staphylococcus au- reus bacteremia. Study Group. N Engl J Med 2001;344:11-16.

Wertheim HFL, Vos MC, Ott A, van Belkum A, Voss A, Kluytmans JA, et al. Risk and outcome of nosoco- mial Staphylococcus aureus bacteraemia in nasal car- riers versus non-carriers. The Lancet 2004; 364:703-705.

Wang CY, Wu VC, Wang WJ, Lin YF, Lin YH, Chen YM, et al. Risk factors for nasal carriage of methicil- lin-resistant Staphylococcus aureus among patients with end-stage renal disease in Taiwan. J Formos Med Assoc 2012; 111:14-18.

Verwer PE, Robinson JO, Coombs GW, Wijesuriya T, Murray RJ, Verbrugh HA, et al. Prevalence of nasal methicillin-resistant Staphylococcus aureus coloni- zation in healthcare workers in a Western Australian acute care hospital. Eur J Clin Microbiol Infect Dis 2012; 31:1067-1072.

Ferrara AM. Treatment of hospital-acquired pneumo- nia caused by methicillin-resistant Staphylococcus au- reus. Int J Antimicrob Agents 2007; 30:19-24.

Hussain FM, Boyle-Vavra S, Daum RS. Commu- nity-acquired methicillin-resistant Staphylococcus aureus colonization in healthy children attending an outpatient pediatric clinic. Pediatr Infect Dis J 2012;20:763-767.

Sedighi I, Moez HJ, Alikhani MY. Nasal carriage of methicillin resistant Staphylococcus aureus and their antibiotic susceptibility patterns in children attending day-care centers. Acta Microbiologica et Immunologi- ca Hungarica 2011; 58:227-234.

Sharifi M, Karimzadeh T, Mohammadi-Chelkasari F, Bijani B, Alipoor-Heydari M. Community–acquired methicillin–resistant Staphylococcus aureus: preva- lence and risk factors. JQUMS 2009; 12:75-82.

Creech CB 2nd, Kernodle DS, Alsentzer A, Wilson C, Edwards KM. Increasing rates of nasal carriage of methicillin-resistant Staphylococcus aureus in healthy children. Pediatr Infect Dis J 2005; 24:617-621.

Brown DF, Edwards DI, Hawkey PM, Morrison D, Ridgway GL, Towner KJ, et al. Guidelines for the lab- oratory diagnosis and susceptibility testing of meth- icillin-resistant Staphylococcus aureus (MRSA). J Antimicrob Chemother 2005; 56:1000-1018.

Wallet F, Roussel-Delvallez M, Courcol RJ. Choice of a routine method for detecting methicillin-resis- tance in staphylococci. J Antimicrob Chemother 1998;37:901-909.

Tremblay C, Gaudreau C. Antimicrobial susceptibili-ty testing of 59 strains of Campylobacter fetus subsp. fetus. Antimicrob Agents Chemother 1998; 42:1847-1849.

Masuda K, Masuda R, Nishi J, Tokuda K, Yoshinaga M, Miyata K. Incidences of nasopharyngeal coloni- zation of respiratory bacterial pathogens in Japanese children attending day-care centers. Pediatr Int 2000;44:376-380.

Oguzkaya-Artan M, Baykan Z, Artan C. Nasal car- riage of Staphylococcus aureus in healthy preschool children. Jpn J Infect Dis 2008; 61:70-72.

Schuchat A, Hilger T, Zell E, Farley MM, Reingold A, Harrison L, et al. Active Bacterial Core Surveillance Team of the Emerging Infections Program Network. Active bacterial core surveillance of the emerging in- fections program network. Emerg Infect Dis 2001; .7:92-99.

Sakoulas G, Gold HS, Venkataraman L, DeGirolami PC, Eliopoulos GM, Qian Q. Methicillin-resistant Staphylococcus aureus: comparison of susceptibility testing methods and analysis of mecA-positive suscep- tible strains. J Clin Microbiol 2001; 39:3946-3951.

Suggs AH, Maranan MC, Boyle-Vavra S, Daum RS.Methicillin-resistant and borderline methicillin-resis- tant asymptomatic Staphylococcus aureus coloniza- tion in children without identifiable risk factors. Pedi- atr Infect Dis J 1999; 18:410-414.

Fritz SA, Garbutt J, Elward A, Shannon W, Storch GA. Prevalence of and risk factors for community-ac- quired methicillin-resistant and methicillin-sensitive Staphylococcus aureus colonization in children seen in a practice-based research network. Pediatrics 2008;121:1090-1098.

Salgado CD, Farr BM, Calfee DP. Community-ac- quired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin In- fect Dis 2003; 36:131-139.

Bignardi GE, Woodford N, Chapman A, Johnson AP, Speller DC. Detection of the mec-A gene and pheno- typic detection of resistance in Staphylococcus aureus isolates with borderline or low-level methicillinresis- tance. J Antimicrob Chemother 1996; 37:53-63.

Files
IssueVol 7 No 2 (2015) QRcode
SectionOriginal Article(s)
Keywords
Staphylococcus aureus CA-MRSA PCR Children

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Nikfar R, Shamsizadeh A, Ziaei-Kajbaf T, Kamali-Panah M, Khaghani S, Moghddam M. Frequency of methicillin-resistant Staphylococcus aureus nasal carriage in healthy children. Iran J Microbiol. 2015;7(2):67-71.