Risk factors and molecular analysis of panton-valentine leukocidin-positive methicillin-resistant Staphylococcus aureus colonization in healthy children

Wen-Tsung Lo, Wei-Jen Lin, Min-Hua Tseng, Sheng-Ru Wang, Mong-Ling Chu, Chih-Chien Wang
Pediatric Infectious Disease Journal 2008, 27 (8): 713-8

BACKGROUND: Nasal carriage of Panton-Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (MRSA) is associated with community associated disease. The risk factors for and characteristics of PVL-positive MRSA colonization in the healthy pediatric population are not well understood.

METHODS: Anterior nares cultures were obtained from healthy children < or =14 years of age presenting for health maintenance visits or attending 1 of 8 kindergartens during a 3-year period. A case-control study and molecular typing studies were performed.

RESULTS: A total of 131 (8.1%) of 1615 children had nares cultures positive for MRSA, and 25 (1.5%) were colonized with PVL-positive MRSA. Nasal colonization of PVL-positive MRSA was significantly higher in 2006 than in 2004 (2.8% versus 0.7%; P = 0.006). By multivariate analysis, antibiotic use during the past 12 months (odds ratio, 29.37; 95% confidence interval, 10.72-80.50; P < 0.001) was the major risk factor associated with PVL-positive MRSA colonization in healthy children. Comparison of hospital MRSA strains with the community colonization strains by antimicrobial susceptibility testing, macrolide-lincosamide-streptogramin resistance gene testing, staphylococcal cassette chromosome mec typing, exotoxin profiling, and pulsed-field gel electrophoresis typing revealed that clonal spread of PVL-positive MRSA distinct from clinical hospital strains contributed to the high PVL-positive MRSA burden in the community.

CONCLUSIONS: Nasal PVL-positive MRSA colonization in healthy children with no relationship to the hospital setting has increased significantly in the past 3 years, suggesting that it may be a major factor in the emergence of community-acquired MRSA disease in Taiwan. Previous antibiotic use was associated with PVL-positive MRSA colonization.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"