title: Fingernail Carriage of Methicillin-Resistant Staphylococcus aureus and Possible Correlation with Soft Tissue Infections in Children.
abstract: OBJECTIVE
  Community-associated methicillin-resistant Staphylococcus aureus (MRSA) is a growing problem in the pediatric population, causing many soft tissue infections. This study was designed to examine fingernail carriage of MRSA in children and their caregivers as a possible link to community-associated MRSA soft tissue infections in children.
  
  
  METHODS
  We documented the prevalence of MRSA under the fingernails of children and the caregivers of pediatric patients with soft tissue infections and compared the prevalence with MRSA under the fingernails of children and the caregivers of children with no history of soft tissue infections. Children with soft tissue infections and their caregivers (50 subjects) had three fingernails of each hand swabbed and plated and these were compared with a control group of children and their caregivers (150 subjects) who had no history of MRSA or soft tissue infection.
  
  
  RESULTS
  Caregivers and children in the study group were more likely than caregivers and the children in the control group to have MRSA under their fingernails (P < 0.05). Soft tissue infections in the study group were found most commonly in the diapering area (66%).
  
  
  CONCLUSIONS
  MRSA carriage was evident under the fingernails of children and caregivers. Caregivers and their children who have soft tissue infections are more likely to have MRSA growth under fingernails than caregivers or their children who have no history of MRSA or soft tissue infections. Our study suggests that caregivers could be contributing to soft tissue infections in their children.
authors.affiliation: From the Pediatric Infectious Disease, Greenville Hospital Pediatrics, Greenville, South Carolina; and Boston Children's Hospital, Boston, MA.
authors.forename: Kathryn D
authors.initials: KD
authors.lastname: Muschick
authors.affiliation: From the Pediatric Infectious Disease, Greenville Hospital Pediatrics, Greenville, South Carolina; and Boston Children's Hospital, Boston, MA.
authors.forename: Robin
authors.initials: R
authors.lastname: LaCroix
authors.affiliation: From the Pediatric Infectious Disease, Greenville Hospital Pediatrics, Greenville, South Carolina; and Boston Children's Hospital, Boston, MA.
authors.forename: Jillian
authors.initials: J
authors.lastname: McAdams
mesh_terms: D000293:Adolescent; D017028:Caregivers; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D009262:Nails / Q000382:microbiology*; D015995:Prevalence; D018461:Soft Tissue Infections / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D013022:South Carolina / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission