Importance of colonization site in the current epidemic of staphylococcal skin abscesses.
OBJECTIVE
The goal was to compare rectal and nasal Staphylococcus aureus colonization rates and S aureus pulsed-field types (PFTs) for children with S aureus skin and soft-tissue abscesses and normal control subjects.


METHODS
Sixty consecutive children with S aureus skin and soft-tissue abscesses that required surgical drainage and 90 control subjects were enrolled. Cultures of the nares and rectum were taken in both groups. S aureus isolates from all sites were characterized through multiple-locus, variable-number, tandem-repeat analysis, pulsed-field gel electrophoresis, staphylococcal cassette chromosome mec typing for methicillin-resistant S aureus isolates, and determination of the presence of Panton-Valentine leukocidin genes.


RESULTS
S aureus was detected significantly more often in the rectum of children with abscesses (47%) compared with those in the control group (1%; P = .0001). Rates of nasal colonization with S aureus were equivalent for children with abscesses (27%) and control subjects (20%; P = .33). S aureus recovered from the rectum was identical to S aureus in the abscess in 88% of cases, compared with 75% of nasal isolates. PFT USA300, staphylococcal cassette chromosome mec type IV, and Panton-Valentine leukocidin genes were significantly increased in the S aureus isolates from children with abscesses compared with those from control subjects.


CONCLUSIONS
Skin and soft-tissue abscesses in the current epidemic of community-associated staphylococcal disease are strongly associated with rectal colonization by PFT USA300. Nasal colonization in children does not seem to be a risk factor.
Division of Infectious Diseases, Women and Children's Hospital of Buffalo, 219 Bryant St, Buffalo, NY 14222, USA. hfaden@upa.chob.edu
Howard
H
Faden
Alan J
AJ
Lesse
Jennifer
J
Trask
January A
JA
Hill
Donavon J
DJ
Hess
Diane
D
Dryja
Yi-Horng
YH
Lee
D000038:Abscess / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009666:Nose / Q000382:microbiology*; D012007:Rectum / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000382:microbiology*