Household can be source of S aureus infection

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Household contacts of children infected with Staphylococcus aureus skin and soft tissue infections (SSTIs) are not routinely sampled for S aureus colonization. Failure to do so may facilitate persistent colonization or recurrent infections, according to a new report. More >>

More than 50% of household contacts of children with Staphylococcus aureus skin and soft tissue infections (SSTIs) are also colonized with the organism. Household contacts of infected children are not routinely sampled for S aureus colonization, and failure to do so may facilitate persistent colonization or recurrent infections, according to a new report.

Children who are treated for an S aureus infection sometimes reacquire the organism from colonized but asymptomatic household members. To assess the prevalence of colonization in the households of children with S aureus infections, researchers screened patients aged 6 months to 20 years who presented to a hospital emergency department or community pediatric practice with acute SSTIs. Index patients (n=183) with community-associated SSTI and S aureus colonization and their household contacts (n=609) were enrolled in the cross-sectional study.

Of the index patients, 112 (61%) were colonized with methicillin-resistant S aureus (MRSA) only, 54 (30%) with methicillin-sensitive S aureus (MSSA) only, and 17 (9%) with MRSA and MSSA. Of the household contacts who provided colonization swabs, 323 (53%) were colonized with S aureus: 115 (19%) with MRSA only, 195 (32%) with MSSA only, and 13 (2%) with MRSA and MSSA. Parents were more likely than other household contacts to be colonized with MRSA.

The anterior nares were the most frequent site of colonization (68%), followed by inguinal folds (57%) and axilla (34%). Researchers note that if only the anterior nares had been sampled, S aureus colonization would have been missed in 37% of index patients and 29% of colonized contacts.

Better understanding of the relationship between S aureus colonization and development of S aureus infections could help in devising prevention and treatment strategies, researchers say.

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Courtney Nelson, MD
Tina Tan, MD, FAAP, FIDSA, FPIDS, editor in chief, Contemporary Pediatrics, professor of pediatrics, Feinberg School of Medicine, Northwestern University, pediatric infectious diseases attending, Ann & Robert H. Lurie Children's Hospital of Chicago
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