title: Nasal carriage screening of community-associated methicillin resistant Staphylococcus aureus in healthy children of a developing country.
abstract: BACKGROUND
  The rapid emergence and spread of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has raised considerable public health concern in both developed and developing countries. The current study aimed to address the extent of this phenomenon in healthy preschool children of a developing country.
  
  
  METHODS
  We conducted a prospective study from April 2013 to March 2014 on 410 healthy 2-6 years old preschool children in Isfahan, Iran. Demographic medical data and nasal samples were collected from the participating children. Isolates were identified as S. aureus and MRSA based on microbiological and molecular tests, including the presence of eap and mecA genes.
  
  
  RESULTS
  The overall prevalence of S. aureus and CA-MRSA nasal carriage was 28% (115/410) and 6.1% (25/410), respectively. The identity of isolates was confirmed by molecular assay. The factors that were independently associated with nasal carriage of S. aureus were: Children crowding in day-care nurseries and income level of families. A total of 20/90 (22.2%) of methicillin-susceptible S. aureus and all 25 CA-MRSA displayed multiple drug resistance to 3-8 antibiotics.
  
  
  CONCLUSIONS
  The current report reflects issues and concerns that the high rate of colonization by CA-MRSA in Iranian healthy children provides obliging evidence that MRSA have established a foothold in the community and are emerging as important health threatening pathogens. It is suggested that we need more effective infection control measures to prevent transmission of nasal CA-MRSA in healthy preschool children.
authors.affiliation: Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Sina
authors.initials: S
authors.lastname: Mobasherizadeh
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Hasan
authors.initials: H
authors.lastname: Shojaei
authors.affiliation: Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Seyed Asghar
authors.initials: SA
authors.lastname: Havaei
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Mostafavizadeh
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Fazlollah
authors.initials: F
authors.lastname: Davoodabadi
authors.affiliation: Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Farzin
authors.initials: F
authors.lastname: Khorvash
authors.affiliation: Department of Epidemiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ali Mehrabi
authors.initials: AM
authors.lastname: Kushki
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Daei-Naser
authors.affiliation: Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Fahimeh
authors.initials: F
authors.lastname: Ghanbari
keywords: Community acquired; Staphylococcus aureus; drug resistance; methicillin-resistant Staphylococcus aureus