title: Does Staphylococcus aureus nasal carriage require eradication prior to elective ambulatory surgery in children?
abstract: OBJECTIVE
  Rates of community-associated Staphylococcus aureus, and particularly of methicillin-resistant Staphylococcus aureus (MRSA) in children, have increased in recent years. We investigated rates of nasal colonization of S. aureus, and a possible correlation between nasal carriage and wound infection.
  
  
  METHODS
  A prospective study of children scheduled for elective day-care surgical procedures between January 2008 and December 2012 at one medical center. Nasal swabs were taken before surgery, and follow-up was performed 1-2 weeks following surgery.
  
  
  RESULTS
  Of 1,127 children (median age 2 years, 70.6% males), positive nasal swabs were detected in 228 (20.2%). Rates of S. aureus nasal carriage were lowest for ages 6 months to 2 years and highest for ages 4-11 years. Child's sex did not associate with the risk for positive nasal swabs. Positive nasal swabs for MRSA were detected in five boys (0.62% of the population). Five children (0.44%) had wound infection. None of them was a nasal carrier.
  
  
  CONCLUSIONS
  No correlation was observed between positive nasal swabs and wound infection in children who were candidates for elective ambulatory operations. This suggests that evaluation of S. aureus nasal carriage and eradication may not be necessary in this population.
authors.affiliation: Department of Pediatric Surgery B, Hillel Yaffe Medical Center, Hadera, Israel, tzvikast@012.net.il.
authors.forename: Zvi
authors.initials: Z
authors.lastname: Steiner
authors.forename: Orna Ben
authors.initials: OB
authors.lastname: Natan
authors.forename: Igor
authors.initials: I
authors.lastname: Sukhotnik
authors.forename: Arnold G
authors.initials: AG
authors.lastname: Coran
authors.forename: Gershon
authors.initials: G
authors.lastname: Keren
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D002353:Carrier State / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D009666:Nose / Q000382:microbiology*; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control