title: Risk of Skin and Soft Tissue Infections among Children Found to beStaphylococcus aureusMRSA USA300 Carriers.
abstract: BACKGROUND
  The purpose of this study was to examine community-associated methicillin resistantStaphylococcus aureus(CA-MRSA) carriage and infections and determine risk factors associated specifically with MRSA USA300.
  
  
  METHODS
  We conducted a case control study in a pediatric emergency department. Nasal and axillary swabs were collected, and participants were interviewed for risk factors. The primary outcome was the proportion ofS. aureuscarriers among those presenting with and without a skin and soft tissue infection (SSTI). We further categorizedS. aureuscarriers into MRSA USA300 carriers or non-MRSA USA300 carriers.
  
  
  RESULTS
  We found the MRSA USA300 carriage rate was higher in children less than two years of age, those with an SSTI, children with recent antibiotic use, and those with a family history of SSTI. MRSA USA300 carriers were also more likely to have lower income compared to non-MRSA USA300 carriers and noS. aureuscarriers. Rates of Panton-Valentine leukocidin (PVL) genes were higher in MRSA carriage isolates with an SSTI, compared to MRSA carriage isolates of patients without an SSTI. There was an association between MRSA USA300 carriage and presence of PVL in those diagnosed with an abscess.
  
  
  CONCLUSIONS
  Children younger than two years were at highest risk for MRSA USA300 carriage. Lower income, recent antibiotic use, and previous or family history of SSTI were risk factors for MRSA USA300 carriage. There is a high association between MRSA USA300 nasal/axillary carriage and presence of PVL in those with abscesses.
authors.affiliation: Morehouse School of Medicine, Clinical Research Center, Departments of Microbiology, Biochemistry, Immunology and Pediatrics, Atlanta, Georgia; Emory University, Department of Pediatrics, Atlanta, Georgia.
authors.forename: Lilly Cheng
authors.initials: LC
authors.lastname: Immergluck
authors.affiliation: Emory University, Department of Pediatrics, Atlanta, Georgia.
authors.forename: Shabnam
authors.initials: S
authors.lastname: Jain
authors.affiliation: Emory University, Department of Medicine, Divison of Infectious Diseases, Atlanta, Georgia.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ray
authors.affiliation: Morehouse School of Medicine, Department of Community Health & Preventive Medicine, Atlanta, Georgia.
authors.forename: Robert
authors.initials: R
authors.lastname: Mayberry
authors.affiliation: Emory University, Department of Medicine, Divison of Infectious Diseases, Atlanta, Georgia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Satola
authors.affiliation: Postgraduate Medical Institute, Anglia Ruskin University Clinical Trials Unit, Chelmsford, United Kingdom.
authors.forename: Trisha Chan
authors.initials: TC
authors.lastname: Parker
authors.affiliation: Morehouse School of Medicine, Department of Community Health & Preventive Medicine, Atlanta, Georgia.
authors.forename: Keming
authors.initials: K
authors.lastname: Yuan
authors.affiliation: Pediatric Emergency Medicine Associates, Atlanta, Georgia.
authors.forename: Anaam
authors.initials: A
authors.lastname: Mohammed
authors.affiliation: Emory University, Department of Pathology, Atlanta, Georgia.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Jerris
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002353:Carrier State / Q000382:microbiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests / Q000379:methods; D015995:Prevalence; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000453:epidemiology / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents