Genotypic distribution of Staphylococcus aureus colonizing children and adolescents in daycare centers, an outpatient clinic, and hospitals in a major Brazilian urban setting

Diagn Microbiol Infect Dis. 2020 Jul;97(3):115058. doi: 10.1016/j.diagmicrobio.2020.115058. Epub 2020 Apr 8.

Abstract

Staphylococcus aureus nasal colonization is a major risk factor for infection. Studies have suggested an epidemiologic shift in the methicillin-resistant S. aureus (MRSA) strains that circulate in Brazil. We conducted cross-sectional studies of MRSA carriage among 1) children and adolescents in community daycare centers, 2) an outpatient clinic, and 3) hospitals in a large Brazilian metropolitan setting. There were 1.500 study subjects, 500 from each locale: 768 (51.2%) carried S. aureus whereas 150 (10%) of these were colonized with MRSA. The most common lineages were the Southwest Pacific (SWP) and the Pediatric clones in all three groups. Roughly 50% of SWP carried Panton-Valentine leukocidin (PVL) (p < 0.01) genes while 63.3% of the Pediatric clones were resistant or intermediately resistant to erythromycin (p < 0.01). This study describes a clonal change of the Brazilian epidemic clone (BEC) to the Pediatric and SWP lineages in Brazil. This finding has implications for clinical management of MRSA infections.

Keywords: Colonization, pediatric; MRSA; USA1100; USA800.

MeSH terms

  • Ambulatory Care Facilities
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Toxins / genetics
  • Brazil / epidemiology
  • Carrier State
  • Child
  • Child Day Care Centers
  • Child, Preschool
  • Cities / epidemiology
  • Cross-Sectional Studies
  • Exotoxins / genetics
  • Female
  • Genotype
  • Hospitals, Public
  • Humans
  • Infant
  • Leukocidins / genetics
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Methicillin-Resistant Staphylococcus aureus / genetics
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Microbial Sensitivity Tests
  • Nasal Mucosa / microbiology
  • Prevalence
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / genetics*
  • Staphylococcus aureus / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Bacterial Toxins
  • Exotoxins
  • Leukocidins
  • Panton-Valentine leukocidin