Cargando…

Epidemiology and risk factors for Staphylococcus aureus colonization in children in the post-PCV7 era

BACKGROUND: The incidence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) has risen dramatically in the U.S., particularly among children. Although Streptococcus pneumoniae colonization has been inversely associated with S. aureus colonization in unvaccinated children, thi...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Grace M, Huang, Susan S, Rifas-Shiman, Sheryl L, Hinrichsen, Virginia L, Pelton, Stephen I, Kleinman, Ken, Hanage, William P, Lipsitch, Marc, McAdam, Alexander J, Finkelstein, Jonathan A
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716346/
https://www.ncbi.nlm.nih.gov/pubmed/19594890
http://dx.doi.org/10.1186/1471-2334-9-110
_version_ 1782169809987829760
author Lee, Grace M
Huang, Susan S
Rifas-Shiman, Sheryl L
Hinrichsen, Virginia L
Pelton, Stephen I
Kleinman, Ken
Hanage, William P
Lipsitch, Marc
McAdam, Alexander J
Finkelstein, Jonathan A
author_facet Lee, Grace M
Huang, Susan S
Rifas-Shiman, Sheryl L
Hinrichsen, Virginia L
Pelton, Stephen I
Kleinman, Ken
Hanage, William P
Lipsitch, Marc
McAdam, Alexander J
Finkelstein, Jonathan A
author_sort Lee, Grace M
collection PubMed
description BACKGROUND: The incidence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) has risen dramatically in the U.S., particularly among children. Although Streptococcus pneumoniae colonization has been inversely associated with S. aureus colonization in unvaccinated children, this and other risk factors for S. aureus carriage have not been assessed following widespread use of the heptavalent pneumococcal conjugate vaccine (PCV7). Our objectives were to (1) determine the prevalence of S. aureus and MRSA colonization in young children in the context of widespread use of PCV7; and (2) examine risk factors for S. aureus colonization in the post-PCV7 era, including the absence of vaccine-type S. pneumoniae colonization. METHODS: Swabs of the anterior nares (S. aureus) were obtained from children enrolled in an ongoing study of nasopharyngeal pneumococcal colonization of healthy children in 8 Massachusetts communities. Children 3 months to <7 years of age seen for well child or sick visits in primary care offices from 11/03–4/04 and 10/06–4/07 were enrolled. S. aureus was identified and antibiotic susceptibility testing was performed. Epidemiologic risk factors for S. aureus colonization were collected from parent surveys and chart reviews, along with data on pneumococcal colonization. Multivariate mixed model analyses were performed to identify factors associated with S. aureus colonization. RESULTS: Among 1,968 children, the mean age (SD) was 2.7 (1.8) years, 32% received an antibiotic in the past 2 months, 2% were colonized with PCV7 strains and 24% were colonized with non-PCV7 strains. The prevalence of S. aureus colonization remained stable between 2003–04 and 2006–07 (14.6% vs. 14.1%), while MRSA colonization remained low (0.2% vs. 0.9%, p = 0.09). Although absence of pneumococcal colonization was not significantly associated with S. aureus colonization, age (6–11 mo vs. ≥5 yrs, OR 0.39 [95% CI 0.24–0.64]; 1–1.99 yrs vs. ≥5 yrs, OR 0.35 [0.23–0.54]; 2–2.99 yrs vs. ≥5 yrs, OR 0.45 [0.28–0.73]; 3–3.99 yrs vs. ≥5 yrs, OR 0.53 [0.33–0.86]) and recent antibiotic use were significant predictors in multivariate models. CONCLUSION: In Massachusetts, S. aureus and MRSA colonization remained stable from 2003–04 to 2006–07 among children <7 years despite widespread use of pneumococcal conjugate vaccine. S. aureus nasal colonization varies by age and is inversely correlated with recent antibiotic use.
format Text
id pubmed-2716346
institution National Center for Biotechnology Information
language English
publishDate 2009
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-27163462009-07-28 Epidemiology and risk factors for Staphylococcus aureus colonization in children in the post-PCV7 era Lee, Grace M Huang, Susan S Rifas-Shiman, Sheryl L Hinrichsen, Virginia L Pelton, Stephen I Kleinman, Ken Hanage, William P Lipsitch, Marc McAdam, Alexander J Finkelstein, Jonathan A BMC Infect Dis Research Article BACKGROUND: The incidence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) has risen dramatically in the U.S., particularly among children. Although Streptococcus pneumoniae colonization has been inversely associated with S. aureus colonization in unvaccinated children, this and other risk factors for S. aureus carriage have not been assessed following widespread use of the heptavalent pneumococcal conjugate vaccine (PCV7). Our objectives were to (1) determine the prevalence of S. aureus and MRSA colonization in young children in the context of widespread use of PCV7; and (2) examine risk factors for S. aureus colonization in the post-PCV7 era, including the absence of vaccine-type S. pneumoniae colonization. METHODS: Swabs of the anterior nares (S. aureus) were obtained from children enrolled in an ongoing study of nasopharyngeal pneumococcal colonization of healthy children in 8 Massachusetts communities. Children 3 months to <7 years of age seen for well child or sick visits in primary care offices from 11/03–4/04 and 10/06–4/07 were enrolled. S. aureus was identified and antibiotic susceptibility testing was performed. Epidemiologic risk factors for S. aureus colonization were collected from parent surveys and chart reviews, along with data on pneumococcal colonization. Multivariate mixed model analyses were performed to identify factors associated with S. aureus colonization. RESULTS: Among 1,968 children, the mean age (SD) was 2.7 (1.8) years, 32% received an antibiotic in the past 2 months, 2% were colonized with PCV7 strains and 24% were colonized with non-PCV7 strains. The prevalence of S. aureus colonization remained stable between 2003–04 and 2006–07 (14.6% vs. 14.1%), while MRSA colonization remained low (0.2% vs. 0.9%, p = 0.09). Although absence of pneumococcal colonization was not significantly associated with S. aureus colonization, age (6–11 mo vs. ≥5 yrs, OR 0.39 [95% CI 0.24–0.64]; 1–1.99 yrs vs. ≥5 yrs, OR 0.35 [0.23–0.54]; 2–2.99 yrs vs. ≥5 yrs, OR 0.45 [0.28–0.73]; 3–3.99 yrs vs. ≥5 yrs, OR 0.53 [0.33–0.86]) and recent antibiotic use were significant predictors in multivariate models. CONCLUSION: In Massachusetts, S. aureus and MRSA colonization remained stable from 2003–04 to 2006–07 among children <7 years despite widespread use of pneumococcal conjugate vaccine. S. aureus nasal colonization varies by age and is inversely correlated with recent antibiotic use. BioMed Central 2009-07-11 /pmc/articles/PMC2716346/ /pubmed/19594890 http://dx.doi.org/10.1186/1471-2334-9-110 Text en Copyright ©2009 Lee et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Lee, Grace M
Huang, Susan S
Rifas-Shiman, Sheryl L
Hinrichsen, Virginia L
Pelton, Stephen I
Kleinman, Ken
Hanage, William P
Lipsitch, Marc
McAdam, Alexander J
Finkelstein, Jonathan A
Epidemiology and risk factors for Staphylococcus aureus colonization in children in the post-PCV7 era
title Epidemiology and risk factors for Staphylococcus aureus colonization in children in the post-PCV7 era
title_full Epidemiology and risk factors for Staphylococcus aureus colonization in children in the post-PCV7 era
title_fullStr Epidemiology and risk factors for Staphylococcus aureus colonization in children in the post-PCV7 era
title_full_unstemmed Epidemiology and risk factors for Staphylococcus aureus colonization in children in the post-PCV7 era
title_short Epidemiology and risk factors for Staphylococcus aureus colonization in children in the post-PCV7 era
title_sort epidemiology and risk factors for staphylococcus aureus colonization in children in the post-pcv7 era
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716346/
https://www.ncbi.nlm.nih.gov/pubmed/19594890
http://dx.doi.org/10.1186/1471-2334-9-110
work_keys_str_mv AT leegracem epidemiologyandriskfactorsforstaphylococcusaureuscolonizationinchildreninthepostpcv7era
AT huangsusans epidemiologyandriskfactorsforstaphylococcusaureuscolonizationinchildreninthepostpcv7era
AT rifasshimansheryll epidemiologyandriskfactorsforstaphylococcusaureuscolonizationinchildreninthepostpcv7era
AT hinrichsenvirginial epidemiologyandriskfactorsforstaphylococcusaureuscolonizationinchildreninthepostpcv7era
AT peltonstepheni epidemiologyandriskfactorsforstaphylococcusaureuscolonizationinchildreninthepostpcv7era
AT kleinmanken epidemiologyandriskfactorsforstaphylococcusaureuscolonizationinchildreninthepostpcv7era
AT hanagewilliamp epidemiologyandriskfactorsforstaphylococcusaureuscolonizationinchildreninthepostpcv7era
AT lipsitchmarc epidemiologyandriskfactorsforstaphylococcusaureuscolonizationinchildreninthepostpcv7era
AT mcadamalexanderj epidemiologyandriskfactorsforstaphylococcusaureuscolonizationinchildreninthepostpcv7era
AT finkelsteinjonathana epidemiologyandriskfactorsforstaphylococcusaureuscolonizationinchildreninthepostpcv7era