Infant colonization by Staphylococcus aureus: role of maternal carriage

Chatzakis, E.; Scoulica, Effie; Papageorgiou, N.; Maraki, Sofia; Samonis, George; Galanakis, Emmanouil

doi:10.1007/s10096-011-1199-9

Cited by 25 publications

(29 citation statements)

References 25 publications

(49 reference statements)

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“…This low risk of infection despite high colonization rate is in keeping with the study of Chatzakis et al who showed that during one year of follow up of 128 infants from birth, infants with NP colonization with SA did not have any invasive infection [3]. Nonetheless, infrequent occurrence of infection has been documented among colonized young infants [4].…”

Section: Discussionsupporting

confidence: 76%

“…Children and adolescents under 20 year of age have higher persistent carriage rates than adults [1-2]. Infants are known to be colonized with SA soon after birth [3-6]. The known risk factors for infant SA colonization include breastfeeding, number of household members, low birth weight, early gestational age at birth, indwelling catheters, and duration of antibiotic or ventilator days.…”

Section: Introductionmentioning

confidence: 99%

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Factors Affecting Staphylococcus aureus Colonization of the Nasopharynx in the First 6 Months of Life

Patel

Alvarez-Fernandez

Jennings

et al. 2015

Pediatric Infectious Disease Journal

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Background Staphylococcal aureus (SA) colonization in early infancy is common, but the pattern and factors affecting its acquisition and persistence in the first few months of life are not well studied. Objectives To study the rate of SA nasopharyngeal (NP) colonization at monthly intervals in the first six months of life, and its association with environmental and host factors, and other pathogenic NP bacteria. Methods Data from a prospective study were analyzed on bacterial cultures of 1765 NP swabs from 367 infants who were followed from birth to 6 months of age. Demographic, breastfeeding, cigarette smoke exposure and daycare attendance data were collected at each monthly visit. Results The rate of infants colonized with SA was highest at age 1 month (25%) and declined to lowest rate by age 6 months (12%). The proportion of SA strains that was methicillin-resistant (MRSA) was also highest at age 1 month and declined rapidly by age 4 months (18% vs 6%, P = 0.05). Colonization with Streptococcus pneumoniae (SP), nontypeable Haemophilus influenzae (HI) and Moraxella catarrhalis (MC) increased at different rates up to age 6 months. Univariate analysis showed that SA colonization rate was significantly lower with increasing age, black race, day care attendance, and colonization with NTHI, MC and SP (P <0.05). Multivariate analysis showed that this effect was independently associated only with increasing age and MC colonization (P ≤0.05). Furthermore, the time to first acquisition of SA from one month of age onwards was significantly associated with day care attendance, and NTHI and MC colonization. None of the infants colonized with SA developed SA infections through age 6 months. Conclusions SA colonization of NP begins very early in life and declines quickly. MRSA has lower ability to maintain prolonged colonization status than methicillin-susceptible strains in the first 6 months of life. As the NP is colonized with other respiratory bacterial pathogens, the colonization with SA declines; however, this effect is stronger with Gram negative bacteria such as NTHI and MC.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Factors Affecting Staphylococcus aureus Colonization of the Nasopharynx in the First 6 Months of Life

Patel

Alvarez-Fernandez

Jennings

et al. 2015

Pediatric Infectious Disease Journal

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“…In 2007-9 in Memphis, Tennessee, among 50 maternal-infant pairs studied up to 4 months post-partum who had concurrent MRSA colonization, 76% had isolate pairs of the same pulsotype, and 30% of the pairs both carried USA300, most identified only long after birth (17•). Although the molecular epidemiology of MRSA differs in Europe, a study from a Greek hospital had similar results (18). …”

Section: Maternal and Infant Mrsa Colonizationmentioning

confidence: 88%

Update on Epidemiology and Treatment of MRSA Infections in Children

David

Daum

2013

Curr Pediatr Rep

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In 2000-10 the epidemiology of pediatric MRSA infections in the United States was transformed with an epidemic of CA-MRSA infections. We review the epidemiology of MRSA in the community and in the health care setting, including intensive care units, among infants and CF patients, and in households as well as the impact that the CA-MRSA epidemic has had on hospitalization with MRSA infections. Risk factors for carriage, transmission, and initial and recurrent infection with MRSA are discussed. New studies on the treatment of pediatric MRSA infections and on the efficacy of MRSA decolonization are reviewed.

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“…Breastfeeding (Peacock et al 2003), number of older siblings (Peacock et al 2003;Chatzakis et al 2011) and maternal smoking (Chatzakis et al 2011) have all been demonstrated to increase the odds for infant carriage. However, these factors were not associated with infant carriage in the study by Lebon et al (2008).…”

Section: Carriage and Colonizationmentioning

confidence: 99%

Infection control of Staphylococcus aureus : spa typing to elucidate transmission

Mernelius¹

2015

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Staphylococcus aureus is a commensal of the human flora, primarily colonizing the anterior nares and throat, but it may also cause infections ranging from mild skin and soft tissue infections to severe diseases such as endocarditis and septicemia. S. aureus is also a major nosocomial problem increasing with the worldwide dissemination of methicillin-resistant S. aureus (MRSA).The main vector for bacterial cross-transmission in healthcare settings is the hands of healthcare workers (HCWs). No S. aureus was detected in the air in this thesis demonstrating that transmission through air is not important. Despite the fact that good compliance with hand hygiene is essential to prevent cross-transmission the compliance is generally less than 50 %.Gold standard to track bacterial transmission in healthcare settings has for long been pulsedfield gel electrophoresis (PFGE), a method that is labor-intensive, lacks consensus protocol and relies on semi-subjective analysis. Molecular typing by sequencing of the hypervariable part of the S. aureus protein A gene (spa typing) has overcome these problems and has shown promising results in epidemiological investigations.The aims of this thesis were to study bacterial transmission with S. aureus colonization of newborn infants as a model and to evaluate spa typing as a molecular tool. Additionally, the influence of compliance with hygiene guidelines on S. aureus transmission was assessed.Analysis of 280 MRSA isolates by spa typing revealed excellent typeability and epidemiological concordance and satisfactory discriminatory power. Additionally, spa typing was considered superior to PFGE thanks to its accessibility, ease of use and rapidity. Also, spa typing results are registered in a global database, facilitating inter-laboratory comparison.The prevalence of S. aureus ranged from 41 % to 66 % in the populations studied and males had the highest colonization rate. Throat was the premier colonization site for adults and transmission from individuals colonized in the throat only was documented, suggesting that throat cultures should be included in S. aureus screening programs. The umbilicus was the premier colonization site for newborn infants. Incubating the swabs in enrichment broth prior to plating increased the prevalence of S. aureus positive samples by 46 %, resulting in prevalence viii ranging from 51 % to 70 % in the populations studied. Thus enrichment prior to plating is necessary to determine more truthful S. aureus colonization rates. There were no indications of an institutional flora, as the colonization rates, spa type distribution and antibiotic resistance prevalence were similar among parents and HCWs.Direct observations and self-reporting by HCWs were both validated as tools for monitoring compliance with hygiene guidelines. The compliance with hygiene guidelines was significantly higher following a 10-point hygiene intervention as compared to baseline. The compliance was also higher three years after the intervention in three of four participating departm...

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Infant colonization by Staphylococcus aureus: role of maternal carriage

Cited by 25 publications

References 25 publications

Factors Affecting Staphylococcus aureus Colonization of the Nasopharynx in the First 6 Months of Life

Factors Affecting Staphylococcus aureus Colonization of the Nasopharynx in the First 6 Months of Life

Update on Epidemiology and Treatment of MRSA Infections in Children

Infection control of Staphylococcus aureus : spa typing to elucidate transmission

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