title: Emergence of community-associated methicillin-resistant Staphylococcus aureus carriage in children in Cambodia.
abstract: We previously described the first reported isolation of methicillin-resistant Staphylococcus aureus (MRSA) (a case series of pediatric community-associated MRSA infections) in Cambodia. We define the rate of pediatric MRSA carriage in the same population and characterize the associated bacterial genotypes by using pulsed-field gel electrophoresis and multilocus sequence typing. A prospective cohort study of MRSA carriage conducted over one month at the Angkor Hospital for Children, Siem Reap, Cambodia, identified MRSA carriage in 87 (3.5%) of 2,485 children who came to the outpatient department, and 6 (4.1%) of 145 inpatients, including at least two with cases of nosocomial acquisition. Genotyping of all 93 MRSA isolates resolved 5 genotypes. Most (91%) isolates were assigned to sequence type 834. Only 28 (32%) of 87 MRSA carriers identified in the outpatient department had no history of recent healthcare contact. The study findings have important implications for healthcare in a setting where diagnostic microbiology and access to antimicrobial drugs with efficacy against MRSA are limited.
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. emma.nickerson@addenbrookes.nhs.uk
authors.forename: Emma K
authors.initials: EK
authors.lastname: Nickerson
authors.forename: Vanaporn
authors.initials: V
authors.lastname: Wuthiekanun
authors.forename: Varun
authors.initials: V
authors.lastname: Kumar
authors.forename: Premjit
authors.initials: P
authors.lastname: Amornchai
authors.forename: Nattavut
authors.initials: N
authors.lastname: Wongdeethai
authors.forename: Kheng
authors.initials: K
authors.lastname: Chheng
authors.forename: Narisara
authors.initials: N
authors.lastname: Chantratita
authors.forename: Hor
authors.initials: H
authors.lastname: Putchhat
authors.forename: Janjira
authors.initials: J
authors.lastname: Thaipadungpanit
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Day
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Peacock
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002160:Cambodia / Q000453:epidemiology; D002353:Carrier State / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D021821:Communicable Diseases, Emerging / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D052978:Disk Diffusion Antimicrobial Tests; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006801:Humans; D007223:Infant; D008712:Methicillin / Q000627:therapeutic use; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin