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Prevalence of Nasal Colonization Among Patients With Community-Associated Methicillin-Resistant Staphylococcus aureus Infection and Their Household Contacts

Published online by Cambridge University Press:  02 January 2015

Uzma Zafar ,
Leonard B. Johnson ,
Michel Hanna ,
Kathleen Riederer ,
Mamta Sharma ,
Mohamad G. Fakih ,
Muthayipalayam C. Thirumoorthi ,
Rand Farjo  and
Riad Khatib
Uzma Zafar
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan
Leonard B. Johnson*
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan
Michel Hanna
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan
Kathleen Riederer
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan
Mamta Sharma
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan
Mohamad G. Fakih
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan
Muthayipalayam C. Thirumoorthi
Affiliation:
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan
Rand Farjo
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan
Riad Khatib
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan
*
19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI 48236 ([email protected])
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Abstract

Objective.

To evaluate the prevalence of colonization among patients with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection and their household contacts.

Design.

Prospective, observational laboratory study of nasal colonization among patients and their household members from September 15, 2004, to February 20, 2006.

Setting.

A 600-bed, urban, academic medical center.

Patients.

Fifty-one patients who presented with CA-MRSA infections and 49 household members had cultures of nasal swab specimens performed.

Results.

Skin and soft-tissue infections were seen in 50 patients (98%) and 2 household members. Twenty-one (41%) of 51 patients and 10 (20%) of 49 household members were colonized with MRSA. An additional 5 patients (10%) and 12 household members (24%) were colonized with methicillin-susceptible Staphylococcus aureus. Most MRSA isolates (95%; infective and colonizing) carried the staphylococcal cassette chromosome mec type IV complex, and 67% represented a single clone, identical to USA 300. Of the colonized household members, 5 had isolates related to the patients' infective isolate.

Conclusions.

The frequency of CA-MRSA colonization among household members of patients with CA-MRSA infections is higher than rates reported among the general population. Among colonized household members, only half of the MRSA strains were related to the patients' infective isolate. Within the same household, multiple strains of CA-MRSA may be present.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 8 , August 2007 , pp. 966 - 969
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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References

1. Said-Salim, B, Mathema, B, Kreiswirth, BN. Community-acquired methicillin-resistant Staphylococcus aureus: an emerging pathogen. Infect Control Hosp Epidemiol 2003;24:451–455.CrossRefGoogle ScholarPubMed
2. Wenzel, RP, Perl, TM. The significance of nasal carriage of Staphylococcus aureus and the incidence of postoperative wound infection. J Hosp Infect 1995;31:13–24.Google Scholar
3. Eiff, CV, Becker, K, Machka, K, et al. Nasal carriage as a source of Staphylococcus aureus bacteremia. N Engl J Med 2001;344:11–16.CrossRefGoogle Scholar
4. Kenner, J, O'Connor, T, Piantanida, N, et al. Rates of carriage of methicillin-resistant and methicillin-susceptible Staphylococcus aureus in an outpatient population. Infect Control Hosp Epidemiol 2003;24:439–444.Google Scholar
5. Kuehnert, MJ, Kruszon-Moran, D, Hill, HA, et al. Prevalence of Staphylococcus aureus nasal colonization in the United States 2001-2002. J Infect Dis 2006;193:172–179.CrossRefGoogle ScholarPubMed
6. Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus skin or soft tissue infections in a state prison-Mississippi, 2000. MMWR Morb Mortal Wkly Rep 2001;50:919–922.Google Scholar
7. Jones, TF, Creech, CB, Erwin, P, Baird, SG, Woron, AM, Schaffner, W. Family outbreaks of invasive community-associated methicillin Staphylococcus aureus infection. Clin Infect Dis 2006;42:e76–e78.CrossRefGoogle ScholarPubMed
8. Calfee, DP, Durbin, LJ, Germanson, TP, Toney, DM, Smith, EB, Farr, BM. Spread of methicillin-resistant Staphylococcus aureus (MRSA) among household contacts of individuals with nosocomially acquired MRSA. Infect Control Hosp Epidemiol 2003;24:422–426.Google Scholar
9. Tenover, FC, Arbeit, RD, Goering, RV, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:2233–2239.CrossRefGoogle ScholarPubMed
10. King, MD, Humphrey, BJ, Wang, YF, Kourbatova, EV, Ray, SM, Blumberg, HM. Emergence of community-acquired methicillin-resistant Staphylococcus aureus USA 300 clone as the predominant cause of skin and soft-tissue infections. Ann Intern Med 2006;144:309–317.CrossRefGoogle ScholarPubMed
11. Johnson, LB, Saeed, S, Pawlak, J, Manzor, O, Saravolatz, LD. Clinical and laboratory features of community-associated methicillin-resistant Staphylococcus aureus: is it really new? Infect Control Hosp Epidemiol 2006;27:133–138.CrossRefGoogle ScholarPubMed
12. Zhang, K, McClure, J, Elsayed, S, Louie, T, Conly, JM. Novel multiplex PCR assay for characterization and concomitant subtyping of staphylococcal cassette chromosome mec types I to V in methicillin-resistant Staphylococcus aureus . J Clin Microbiol 2005;43:5026–5033.Google Scholar
13. Ito, T, Ma, XX, Takeuchi, F, Okuma, K, Yuzawa, H, Hiramatsu, K. Novel type V staphylococcal cassette chromosome mec driven by a novel cassette chromosome recombinase, ccrC . Antimicrob Agents Chemother 2004;48:2637–2651.CrossRefGoogle ScholarPubMed
14. Ellis, MW, Hospenthal, DR, Dooley, DP, Gray, PJ, Murray, CK. Natural history of community-acquired methicillin-resistant Staphylococcus aureus colonization and infection in soldiers. Clin Infect Dis 2004;39:971–979.CrossRefGoogle ScholarPubMed
15. Kazakova, SV, Hageman, JC, Matava, M, et al. A clone of methicillin-resistant Staphylococcus aureus among professional football players. N Engl J Med 2005;352:468–475.Google Scholar
16. Charlebois, ED, Bangsberg, DR, Moss, NJ, et al. Population-based community prevalence of methicillin-resistant Staphylococcus aureus in the urban poor of San Francisco. Clin Infect Dis 2002;34:425–433.Google Scholar
17. Eveillard, M, de Lassence, A, Lancien, E, Barnaud, G, Ricard, JD, Joly-Guillou, ML. Evaluation of a strategy of screening multiple anatomical sites for methicillin resistant Staphylococcus aureus at admission to a teaching hospital. Infect Control Hosp Epidemiol 2006;27:181–184.CrossRefGoogle ScholarPubMed
18. Nilsson, P, Ripa, T. Staphylococcus aureus throat colonization is more frequent than colonization in the anterior nares. J Clin Microbiol 2006;44:3334–3339.CrossRefGoogle ScholarPubMed