Community-associated methicillin-resistant Staphylococcus aureus transmission in households of infected cases: a pooled analysis of primary data from three studies across international settings.
Diverse strain types of methicillin-resistant Staphylococcus aureus (MRSA) cause infections in community settings worldwide. To examine heterogeneity of spread within households and to identify common risk factors for household transmission across settings, primary data from studies conducted in New York (USA), Breda (The Netherlands), and Melbourne (Australia) were pooled. Following MRSA infection of the index patient, household members completed questionnaires and provided nasal swabs. Swabs positive for S. aureus were genotyped by spa sequencing. Poisson regression with robust error variance was used to estimate prevalence odds ratios for transmission of the clinical isolate to non-index household members. Great diversity of strain types existed across studies. Despite differences between studies, the index patient being colonized with the clinical isolate at the home visit (P < 0·01) and the percent of household members aged <18 years (P < 0·01) were independently associated with transmission. Targeted decolonization strategies could be used across geographical settings to limit household MRSA transmission.
Division of Infectious Diseases, Department of Medicine,Columbia University,College of Physicians & Surgeons, New York,USA.
J
J
Knox
Amphia Hospital,Breda,The Netherlands.
M
M
Van Rijen
Division of Infectious Diseases, Department of Medicine,Columbia University,College of Physicians & Surgeons, New York,USA.
A-C
AC
Uhlemann
Department of Epidemiology, Mailman School of Public Health,Columbia University;New York,USA.
M
M
Miller
Division of Infectious Diseases, Department of Medicine,Columbia University,College of Physicians & Surgeons, New York,USA.
C
C
Hafer
Panna Technologies,New York,USA.
P
P
Vavagiakis
Department of Epidemiology and Community Health, School of Health Sciences and Practice,New York Medical College,Valhalla,USA.
Q
Q
Shi
Austin Health,Melbourne, Victoria,Australia.
P D R
PD
Johnson
Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Biomedical Sciences,Curtin University,Perth, Western Australia,Australia.
G
G
Coombs
Amphia Hospital,Breda,The Netherlands.
M
M
Kluytmans-Van Den Bergh
Amphia Hospital,Breda,The Netherlands.
J
J
Kluytmans
Deakin University,Melbourne, Victoria,Australia.
C M
CM
Bennett
Division of Infectious Diseases, Department of Medicine,Columbia University,College of Physicians & Surgeons, New York,USA.
F D
FD
Lowy
D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D009426:Netherlands / Q000453:epidemiology; D009518:New York / Q000453:epidemiology; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D055815:Young Adult