Isaac P Thomsen1, Priyanka Kadari2, Nicole R Soper2, Scott Riddell3, Deanna Kiska3, C Buddy Creech2, Jana Shaw4. 1. Division of Pediatric Infectious Diseases, Department of Pediatrics, and Vanderbilt Vaccine Research Program, Vanderbilt University School of Medicine, Nashville, TN. Electronic address: isaac.thomsen@vumc.org. 2. Division of Pediatric Infectious Diseases, Department of Pediatrics, and Vanderbilt Vaccine Research Program, Vanderbilt University School of Medicine, Nashville, TN. 3. Department of Pathology, SUNY Upstate Medical University, Syracuse, NY. 4. Division of Pediatric Infectious Diseases, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY.
Abstract
OBJECTIVES: To characterize Staphylococcus aureus isolates recovered from hospitalized children and to determine the concordance between colonizing and invasive isolates. STUDY DESIGN: Children with culture-confirmed, community-onset, invasive S aureus infections were enrolled in this prospective case series from a large children's hospital over a 5-year period. Colonization isolates were obtained from the anterior nares, oropharynx, and inguinal folds and were compared with invasive isolates via repetitive-element, sequence-based polymerase chain reaction testing. Isolates with a ≥96% genetic match were characterized as concordant. RESULTS: A total of 86 S aureus isolates (44 invasive, 42 colonization) were collected from 44 children with invasive infections. Clinical isolates were genetically diverse, 64% of invasive isolates were methicillin-susceptible S aureus (MSSA), and 59% of cases had a colonizing S aureus isolate at the time of hospitalization. Of those who were colonized, at least 1 of their colonization isolates was indistinguishable from the infecting isolate in 88% of cases. Patients with invasive MSSA were significantly more likely to have a concordant MSSA colonization isolate present compared with patients with invasive methicillin-resistant S aureus (MRSA) (61% vs 38%, P < .05). CONCLUSIONS: Invasive MSSA infection was more common than MRSA infection in this pediatric cohort, and patients with MSSA infection were significantly more likely than those with MRSA infection to have concordant colonizing isolates across multiple anatomic sites. These findings warrant larger scale validation and may have important infection control and epidemiologic implications, as unlike MRSA, transmissibility of MSSA largely is ignored in healthcare settings.
OBJECTIVES: To characterize Staphylococcus aureus isolates recovered from hospitalized children and to determine the concordance between colonizing and invasive isolates. STUDY DESIGN:Children with culture-confirmed, community-onset, invasive S aureus infections were enrolled in this prospective case series from a large children's hospital over a 5-year period. Colonization isolates were obtained from the anterior nares, oropharynx, and inguinal folds and were compared with invasive isolates via repetitive-element, sequence-based polymerase chain reaction testing. Isolates with a ≥96% genetic match were characterized as concordant. RESULTS: A total of 86 S aureus isolates (44 invasive, 42 colonization) were collected from 44 children with invasive infections. Clinical isolates were genetically diverse, 64% of invasive isolates were methicillin-susceptible S aureus (MSSA), and 59% of cases had a colonizing S aureus isolate at the time of hospitalization. Of those who were colonized, at least 1 of their colonization isolates was indistinguishable from the infecting isolate in 88% of cases. Patients with invasive MSSA were significantly more likely to have a concordant MSSA colonization isolate present compared with patients with invasive methicillin-resistant S aureus (MRSA) (61% vs 38%, P < .05). CONCLUSIONS:Invasive MSSA infection was more common than MRSA infection in this pediatric cohort, and patients with MSSA infection were significantly more likely than those with MRSA infection to have concordant colonizing isolates across multiple anatomic sites. These findings warrant larger scale validation and may have important infection control and epidemiologic implications, as unlike MRSA, transmissibility of MSSA largely is ignored in healthcare settings.
Authors: Jovanka M Voyich; Michael Otto; Barun Mathema; Kevin R Braughton; Adeline R Whitney; Diane Welty; R Daniel Long; David W Dorward; Donald J Gardner; Gérard Lina; Barry N Kreiswirth; Frank R DeLeo Journal: J Infect Dis Date: 2006-11-02 Impact factor: 5.226
Authors: Anthony D Harris; Jon P Furuno; Mary-Claire Roghmann; Jennifer K Johnson; Laurie J Conway; Richard A Venezia; Harold C Standiford; Marin L Schweizer; Joan N Hebden; Anita C Moore; Eli N Perencevich Journal: Antimicrob Agents Chemother Date: 2010-05-17 Impact factor: 5.191
Authors: Isaac Thomsen; Brian D McKenna; Elizabeth J Saye; Natalia Jimenez; Kathryn M Edwards; C Buddy Creech Journal: Pediatr Infect Dis J Date: 2011-05 Impact factor: 2.129
Authors: Ashley L Dumont; Tyler K Nygaard; Robert L Watkins; Amanda Smith; Lina Kozhaya; Barry N Kreiswirth; Bo Shopsin; Derya Unutmaz; Jovanka M Voyich; Victor J Torres Journal: Mol Microbiol Date: 2010-12-13 Impact factor: 3.501
Authors: F P N Mollema; J H Richardus; M Behrendt; N Vaessen; W Lodder; W Hendriks; H A Verbrugh; M C Vos Journal: J Clin Microbiol Date: 2009-11-18 Impact factor: 5.948
Authors: Ashley L DuMont; Pauline Yoong; Christopher J Day; Francis Alonzo; W Hayes McDonald; Michael P Jennings; Victor J Torres Journal: Proc Natl Acad Sci U S A Date: 2013-06-10 Impact factor: 11.205
Authors: Jennie H Kwon; Kimberly Reske; Caroline A O'Neil; Candice Cass; Sondra Seiler; Meghan A Wallace; Tiffany Hink; Stephen Y Liang; Victoria J Fraser; Carey-Ann D Burnham; Erik R Dubberke Journal: Infect Control Hosp Epidemiol Date: 2020-01-23 Impact factor: 3.254