Methicillin-resistant Staphylococcus aureus nasal carriage in neonates and children attending a pediatric outpatient clinics in Brazil.
BACKGROUND
In Latin America, few studies have been carried out on methicillin-resistant Staphylococcus aureus carriage in the pediatric population. We conducted a survey of nasal S. aureus carriage in neonates and in children attending the pediatric outpatient clinics in a large Brazilian city with high antimicrobial consumption.


METHODS
Pernasal swabs of neonates were collected upon admission and at discharge in four neonatal intensive care units and of children less than five years of age during outpatient visits. Methicillin-resistant S. aureus isolates were characterized for antibiotic susceptibility, mec gene presence, pulsed-field gel electrophoresis, spa type, SCCmec-type, multilocus sequence type, and presence of Panton-Valentine leukocidin genes.


RESULTS
S. aureus was carried by 9.1% and 20.1% of the 701 neonates and of 2034 children attending the outpatient clinics, respectively; methicillin-resistant S. aureus carriage was detected in 0.6% and 0.2%, of the these populations, respectively. Healthcare-associated methicillin-resistant S. aureus strains found in neonates from neonatal intensive care units and outpatients were genetically related to the Brazilian (SCCmec-III, ST239) and to the Pediatric (SCCmec-IV, ST5) clones. Community-associated methicillin-resistant S. aureus was only detected in outpatients. None of the methicillin-resistant S. aureus strains contained the Panton-Valentine leukocidin gene. Methicillin-resistant S. aureus strains related to the Brazilian clone showed multidrug resistance pattern.


CONCLUSIONS
Despite the high antibiotic pressure in our area, and the cross transmission of the healthcare-associated methicillin-resistant S. aureus clones between neonatal intensive care units and outpatients, the prevalence of methicillin-resistant S. aureus carriage is still low in our setting.
Department of Nursing, Pontifícia Universidade Católica de Goiás, Goiânia, GO, Brazil.
Maria Aparecida
MA
Vieira
Faculty of Nursing, Universidade Federal de Goiás, Goiânia, GO, Brazil. Electronic address: minamisava@gmail.com.
Ruth
R
Minamisava
Department of Community Health, Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia, GO, Brazil.
Vicente
V
Pessoa-Júnior
Department of Microbiology, Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia, GO, Brazil.
Juliana
J
Lamaro-Cardoso
Department of Community Health, Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia, GO, Brazil.
Yves Mauro
YM
Ternes
Department of Microbiology, Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia, GO, Brazil.
Maria Cláudia Porfirio
MC
Andre
Department of Medicine, Pontifícia Universidade Católica de Goiás, Goiânia, GO, Brazil.
Sabrina
S
Sgambatti
Department of Microbiology, Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia, GO, Brazil.
André
A
Kipnis
Department of Community Health, Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia, GO, Brazil.
Ana Lúcia
AL
Andrade
D000554:Ambulatory Care Facilities; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001938:Brazil / Q000453:epidemiology; D002353:Carrier State / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D009296:Nasal Cavity / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology
D000900:Anti-Bacterial Agents
Children; Methicillin-resistant Staphylococcus aureus; Neonates; Staphylococcus aureus carriage