Risk Factors for Methicillin Resistant Staphylococcus aureus Nasal Colonization of Healthy Children

BACKGROUND: Nasal colonization of healthy children with Staphylococcus aureus is an important risk factor for different infections. Detection of colonized individuals with methicillin resistant S. aureus (MRSA) and its eradication is the proper prevention strategy for infection spread in the community and health-care centers. OBJECTIVES: The aim of this study was to determine the prevalence, associated risk factors and antibiotic resistance pattern among healthy children who were nasal carriers of S. aureus. PATIENTS AND METHODS: This cross-sectional study was conducted on 350 one month to 14-year-old healthy children living in Kashan/Iran. The nasal specimens were cultured in blood agar medium for S. aureus. Positive cultures were evaluated for cephalothin, co-trimoxazole, clindamycin, ciprofloxacin, oxacillin and vancomycin susceptibility by the disc diffusion method and E-test. Risk factors for nasal carriage of S. aureus and MRSA were evaluated. RESULTS: Frequency of S. aureus nasal carriage was 92 from 350 cases (26.2%), amongst which 33 (35.9%) were MRSA. Isolates indicated an overall resistance of 52.2% to cephalothin, 33.7% to co-trimoxazol, 26.1% to ciprofloxacin, 26.1% to clindamycin, 35.9% to oxacillin and 4.3% to vancomycin. Factors associated with MRSA nasal carriage included gender (P value 0.001), age of less than four years (P value 0.016), number of individuals in the family (P value < 0.001), antibiotic use (P value < 0.001) and admission (P value < 0.001) during the previous three months, parental smoking (P value < 0.001) and sleeping with parents (P value 0.022). CONCLUSIONS: Age of less than four years, male sex, family size being more than four, antibiotic use and admission during the previous three months, parental smoking and sleeping with parents were independent risk factors for nasal colonization with MRSA.