Nasal Carriage and Antimicrobial Susceptibility of Staphylococcus aureusin healthy preschool children in Ujjain, India

Abstract

BackgroundThere is increasing evidence that community acquired S. aureus infections are spreading among healthy children. Nasal colonization with S. aureus plays pivotal role in the increasing prevalence of resistant community acquired S. aureus infections worldwide. A regular surveillance system is important in ensuring quality of patient care. The aim of the study was to assess the prevalence of and the factors associated with nasal carriage of S. aureus and its antibiotic sensitivity pattern among healthy children in Ujjain, India.MethodsA prospective study was done in paediatric outpatient clinics of R.D. Gardi medical college Ujjain, India. Healthy children from 1 month to 59 months of age were included. Information on previously known risk factors for nasal colonization was collected using a pre-tested questionnaire. Swabs from anterior nares were collected and transported in Amies transport media with charcoal and cultured on 5% sheep blood agar. Antibiotic sensitivity tests were performed using Kirby Bauer's disc diffusion method according to performance standards of Clinical and Laboratory Standard Institute guidelines.ResultsOf the 1,562 children from 1-month up-to five years of age included in the study 98 children tested positive for nasal carriage of S. aureus. The prevalence of nasal carriage of S. aureus was 6.3% (95% CI 5.1-7.5) out of which 16.3% (95% CI 8.9-23.8) were methicillin-resistant S. aureus (MRSA). The factors associated with nasal carriage were "child attending preschool" (OR 4.26, 95% CI 2.25-8.03; P = 0.007) or "school" (OR 3.02, 95% CI 1.27-7.18; P < 0.001) and "family size more than 10 members" (OR 2.76 95% CI 1.06-7.15; P = 0.03). The sensitivity pattern of isolated S. aureus showed resistance to commonly used oral antibiotics while resistance to glycopeptides was not noted.ConclusionsWe found a relatively low rate of nasal carriage of S. aureus in children below five years when compared to children of older age groups in India. Yet, prevalence of MRSA was relatively high.

Prevalence of Community-Acquired Methicillin-Resistant Staphylococcus aureus Nasal Colonization Among Children

“…Our study showed that 25% of healthy children between the age group of 1 mnth -17 y attending primary care clinic were colonized with S. aureus in the anterior nares. Our findings are consistent with previous reports from India [8,10,11].The prevalence of nasal carriage of S. aureus in healthy preschool children aged 1 mnth through 59 mnth was 6.3% in a large study (n=1,562) from Ujjain, India [10]. In another study from Andhra Pradesh, India, a carriage rate of 16% for S. aureus (19% MRSA) was documented [11].…”

“…With a human population of over 1 billion and growing, the microbial milieu within India should be closely monitored, especially with recent reports of global spread antimicrobial resistance [9]. Few studies from India have reported the prevalence of nasal carriage of S. aureus among the healthy preschool children below age four years and two prevalence studies have been conducted in children aged 5 to 15 y of age [10][11][12][13].…”

Prevalence of Multidrug Resistant Staphylococcus aureus and its Antimicrobial Susceptibility Pattern in a Tertiary Care Hospital in Navi Mumbai, India

“…In a study conducted in healthy preschool children in Ujjain, India the Nasal Carriage and Antimicrobial Susceptibility of S. aureus among the 16 MRSA isolates 3 (19%) were MDR which is similar to our result (Ashish Pathak et al, 2010). High percentage (63.6%) of MDRSA has been observed in a study conducted by Rajaduraipandi et al, (2016) Summaiya et al, (2007) found that a high rate of MRSA isolates (26.3%) from the clinical specimens also showed MDRSA.…”

Methicillin resistant Staphylococcus aureus (MRSA) carriage among health care workers in a tertiary care hospital in Bhubaneswar

“…16 Nasal colonization with S. aureus have been reported to range from 6.3 to 17.8% in the general population and in health care workers it varies from 18.2 to 28.2%. 17,18 The maximum prevalence of S. aureus carriage is among nurses (42.9%) and the least was among laboratory technicians (10.2%) (Table 3/ Figure 1). This is in contrast to the study conducted by Radhakrishna et al where the S. aureus carriage was highest among doctors (32.5%) and the least was among nurses (13.6%).…”