title: Methicillin-resistant Staphylococcus aureus nasal colonization in a department of pediatrics: a cross-sectional study.
abstract: BACKGROUND
  We describe methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage at admission in patients admitted to a Department of Pediatrics.
  
  
  METHODS
  All patients received a nasal swab at admission. A questionnaire was administered and molecular genetics analyses were performed on all identified MRSA isolates.
  
  
  RESULTS
  We enrolled 785 patients, affected with both acute and chronic diseases. MRSA nasal colonization prevalence was 1.15% (CI: 0.5607%-2.093%). Methicillin-sensitive Staphylococcus aureus (MSSA) nasal colonization prevalence at admission was 19.75% (CI 17.07%-22.64%). Only one MRSA isolate carried the SCCmec V variant; all other isolates carried the SCCmecIV variant. Five out of 9 MRSA-colonized patients had an underlying condition. Antibiotic therapy in the previous 6 months was a protective factor for both MRSA (OR 0,66; 95% CI: 0,46-0,96) and MSSA (OR 0,65; 95% CI: 0,45-0,97) colonization. A tendency to statistical significance was seen in the association between hospitalization in the 6 months prior to admission and MRSA colonization at admission (OR 4,92; 95% CI: 0,97-24,83). No patient was diagnosed with an S. aureus infection during hospitalization.
  
  
  CONCLUSIONS
  The majority of our MRSA colonizing isolates have community origins. Nevertheless, most MRSA-colonized patients had been hospitalized previously, suggesting that strains that circulate in the community also circulate in hospital settings. Further studies should elucidate the role of children with frequent contact with health care institutions in the circulation of antibiotic resistant strains between the hospital and the community.
authors.affiliation: Bambino Gesù Children's Hospital IRCCS, Rome, Italy. f.gesualdo@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Gesualdo
authors.forename: Manuela
authors.initials: M
authors.lastname: Onori
authors.forename: Dafne
authors.initials: D
authors.lastname: Bongiorno
authors.forename: Floriana
authors.initials: F
authors.lastname: Campanile
authors.forename: Emanuela
authors.initials: E
authors.lastname: Carloni
authors.forename: Livia
authors.initials: L
authors.lastname: Mancinelli
authors.forename: Cristina
authors.initials: C
authors.lastname: Russo
authors.forename: Alberto
authors.initials: A
authors.lastname: Villani
authors.forename: Diletta
authors.initials: D
authors.lastname: Valentini
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Raponi
authors.forename: Alberto E
authors.initials: AE
authors.lastname: Tozzi
authors.forename: Stefania
authors.initials: S
authors.lastname: Stefani
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D009296:Nasal Cavity / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D004269:DNA, Bacterial