Staphylococcus aureus colonization in children with community-associated Staphylococcus aureus skin infections and their household contacts.
OBJECTIVE
To measure prevalence of Staphylococcus aureus colonization in household contacts of children with acute S aureus skin and soft tissue infections (SSTI), determine risk factors for S aureus colonization in household contacts, and assess anatomic sites of S aureus colonization in patients and household contacts.


METHODS
Cross-sectional study.


METHODS
St Louis Children's Hospital Emergency Department and ambulatory wound center and 9 community pediatric practices affiliated with a practice-based research network.


METHODS
Patients with community-associated S aureus SSTI and S aureus colonization (in the nose, axilla, and/or inguinal folds) and their household contacts.


METHODS
Colonization of household contacts of pediatric patients with S aureus colonization and SSTI.


RESULTS
Of 183 index patients, 112 (61%) were colonized with methicillin-resistant S aureus (MRSA); 54 (30%), with methicillin-sensitive S aureus (MSSA); and 17 (9%), with both MRSA and MSSA. Of 609 household contacts, 323 (53%) were colonized with S aureus: 115 (19%) with MRSA, 195 (32%) with MSSA, and 13 (2%) with both. Parents were more likely than other household contacts to be colonized with MRSA (odds ratio, 1.72; 95% CI, 1.12 to 2.63). Methicillin-resistant S aureus colonized the inguinal folds more frequently than MSSA (odds ratio, 1.67; 95% CI, 1.16 to 2.41), and MSSA colonized the nose more frequently than MRSA (odds ratio, 1.75; 95% CI, 1.19 to 2.56).


CONCLUSIONS
Household contacts of children with S aureus SSTI had a high rate of MRSA colonization compared with the general population. The inguinal fold is a prominent site of MRSA colonization, which may be an important consideration for active surveillance programs in hospitals.
Department of Pediatrics, Washington University School of Medicine, 660 South Euclid Ave., St Louis, MO 63110, USA. fritz_s@kids.wustl.edu
Stephanie A
SA
Fritz
Patrick G
PG
Hogan
Genevieve
G
Hayek
Kimberly A
KA
Eisenstein
Marcela
M
Rodriguez
Melissa
M
Krauss
Jane
J
Garbutt
Victoria J
VJ
Fraser
D000293:Adolescent; D002353:Carrier State / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005192:Family Health; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008923:Missouri / Q000453:epidemiology; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000635:transmission; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D011795:Surveys and Questionnaires; D055815:Young Adult