title: Epidemiology of methicillin-resistant Staphylococcus aureus in a university medical center day care facility.
abstract: OBJECTIVE
  Few data are available on methicillin-resistant Staphylococcus aureus (MRSA) colonization in day care. We performed a study in a medical university child care center to study the epidemiology of MRSA in this population.
  
  
  METHODS
  Survey.
  
  
  METHODS
  A child care center on the campus of a university medical center.
  
  
  METHODS
  One hundred four children who attended the child care center and 32 employees gave samples that were cultured for MRSA. Seventeen household members of the children and employee found to be colonized with MRSA also gave samples that were cultured. Parents and employees completed questionnaires about demographic characteristics, medical conditions and treatments, and possible exposure risks outside the child care center. In addition, 195 environmental samples were taken from sites at the childcare center. Isolates were analyzed for relatedness by use of molecular typing, and statistical analysis was performed.
  
  
  RESULTS
  The prevalence of MRSA in the children was 6.7%. One employee (3.1%) was colonized with MRSA. Cultures of samples given by 6 of 17 (35.3%) family members of these children and the employee yielded MRSA. MRSA was recovered from 4 of 195 environmental samples. Molecular typing revealed that many of the MRSA isolates were indistinguishable, and 18 of the 21 isolates were community-associated MRSA. Multivariable analysis revealed that receipt of macrolide antibiotics (P = .002; odds ratio, 39.6 [95% confidence interval, 3.4-651.4]) and receipt of asthma medications (P = .024; odds ratio, 26.9 [95% confidence interval, 1.5-500.7]) were related to MRSA colonization.
  
  
  CONCLUSIONS
  There was a low prevalence of MRSA colonization in children and employees in the child care center but a higher prevalence of colonization in their families. Molecular typing showed that transmission of MRSA likely occurred in the child care center. The use of macrolide antibiotics and asthma medications may increase the risk of MRSA colonization in this population.
authors.affiliation: Department of Healthcare Epidemiology, University of Texas Medical Branch, Galveston, 77555-0770, USA. alhewlet@gmail.com
authors.forename: Angela L
authors.initials: AL
authors.lastname: Hewlett
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Falk
authors.forename: Katrina S
authors.initials: KS
authors.lastname: Hughes
authors.forename: C Glen
authors.initials: CG
authors.lastname: Mayhall
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000328:Adult; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D003470:Culture Media; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D008875:Middle Aged; D009666:Nose / Q000382:microbiology; D009960:Oropharynx / Q000382:microbiology; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013781:Texas / Q000453:epidemiology
chemical_list: D003470:Culture Media