Methicillin-resistant Staphylococcus aureus nasal colonization in children in Jerusalem: community vs. chronic care institutions.
BACKGROUND
Nasal colonization with methicillin-resistant Staphylococcus aureus in the community is being increasingly reported, but there is a general lack of data on MRSA colonization in children in chronic care institutions and on colonization rates in Israeli children.


OBJECTIVE
To define the rate of MRSA nasal colonization in a generally healthy pediatric population in Jerusalem, to compare it with that of children in chronic care institutions, to define risk factors for colonization, and to compare community and hospital-acquired MRSA strains.


METHODS
Anterior nares culture for the presence of methicillin-sensitive and methicillin-resistant S. aureus was taken from 831 healthy children attending primary pediatric clinics or emergency departments and from 118 children hospitalized in three chronic care institutions in Jerusalem.


RESULTS
Of the 831 healthy children, 195 (23.5%) were colonized with S. aureus, as compared to 43 of 118 (36.4%) chronically institutionalized children (P < 0.005). Five of the 195 S. aureus isolates from healthy children (2.6%) were MRSA, as compared to 9 of 43 (21%) from chronically institutionalized children (P < 0.001). Older age and a family member who is a healthcare worker were associated with S. aureus colonization in the population of healthy children, and older age was associated with MRSA colonization in the chronically institutionalized children. The antibiotic susceptibility pattern was similar for both groups, and pulsed field gel electrophoresis of the isolates showed a wide and random distribution in both groups.


CONCLUSIONS
MRSA colonization in the studied pediatric community in Jerusalem was very low, whereas that of patients hospitalized in chronic care institutions was significantly higher. In the small number of isolates detected, no significant differences were found in antibiotic susceptibility or PFGE pattern between hospital-acquired and community-acquired strains.
Schlesinger
Yechiel
Y
Infectious Diseases Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel. yechiel@szmc.org.il
Yahalom
Shira
S
Raveh
David
D
Yinnon
Amos M
AM
Segel
Rival
R
Erlichman
Matityahu
M
Attias
Denise
D
Rudensky
Bernard
B
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003441:Crowding; D016521:Electrophoresis, Gel, Pulsed-Field; D005190:Family; D005260:Female; D006801:Humans; D007223:Infant; D007326:Institutionalization; D007557:Israel; D008297:Male; D016106:Methicillin Resistance; D009297:Nasal Mucosa / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D011795:Surveys and Questionnaires