Division of Pediatric Pulmonology, Department of Pediatrics, Columbia University, New York, NY, USA.
Pediatr Infect Dis J. 2009 Oct;28(10):895-9. doi: 10.1097/inf.0b013e3181a3ad0a.
Little is known about the prevalence of Staphylococcus aureus nasal colonization and the epidemiology of methicillin-susceptible and methicillin-resistant S. aureus (MRSA) among cystic fibrosis (CF) patients and their household members.
We sought to determine the epidemiology of S. aureus among children and adolescents with CF and their household members.
Three CF centers enrolled case subjects with at least 1 MRSA-positive respiratory tract culture from 2001 to 2006 and control subjects with MRSA-negative cultures. S. aureus isolates from the anterior nares of CF subjects and their household members were assessed for staphylococcal chromosomal cassette (SCC) mec type. Strain similarity was determined by pulsed-field gel electrophoresis.
S. aureus nasal colonization occurred in 52.4% (22/42), 27.0% (17/63), and 25.0% (72/288) of case, control, and household participants, respectively. Case subjects and their contacts were more likely to harbor MRSA in their nares and be from a multipatient CF family. Of 31 MRSA strains, 10 (32.3%) were SCCmec type IVa, associated with community-acquisition. Overall, 27.6% of 98 households had > or =2 members colonized with closely related isolates. Household members were equally likely to be colonized with closely related strains of MRSA (20/31, 65%) versus MSSA (38/80, 48%).
This study demonstrated that household members of CF children harbor both MSSA and MRSA, including CA-MRSA, and that S. aureus is transmitted within CF households. Carriage of S. aureus by household members of CF children may have implications for infection control and treatment strategies. Future studies should monitor the distribution and virulence of SCCmecA types in patients with CF.
关于囊性纤维化（CF）患者及其家庭成员中金黄色葡萄球菌（金葡菌）鼻腔定植的流行情况以及耐甲氧西林金黄色葡萄球菌（MRSA）和甲氧西林敏感金黄色葡萄球菌（MSSA）的流行病学情况知之甚少。
我们旨在确定 CF 患儿及其家庭成员中金葡菌的流行病学情况。
三家 CF 中心招募了 2001 年至 2006 年间至少有 1 例 MRSA 阳性呼吸道培养物的 CF 患儿作为病例组，并招募了 MRSA 阴性培养物的 CF 患儿作为对照组。评估 CF 患儿及其家庭成员的鼻腔金葡菌分离株的葡萄球菌染色体盒（SCC）mec 型。通过脉冲场凝胶电泳确定菌株相似性。
52.4%（22/42）、27.0%（17/63）和 25.0%（72/288）的病例组、对照组和家庭成员组的金葡菌鼻腔定植率分别为 52.4%、27.0%和 25.0%。病例组及其接触者鼻腔内更有可能定植 MRSA，且来自多例 CF 患儿的家庭。31 株 MRSA 中，10 株（32.3%）为 SCCmec 型 IVa，与社区获得性感染相关。总体而言，98 个家庭中有 27.6%的家庭有≥2 名成员定植了密切相关的分离株。家庭成员与密切相关的 MRSA 定植（20/31，65%）与 MSSA 定植（38/80，48%）的可能性相同。
本研究表明 CF 患儿的家庭成员携带 MSSA 和 MRSA，包括社区获得性 MRSA，金葡菌在 CF 家庭中传播。CF 患儿家庭成员携带金葡菌可能对感染控制和治疗策略产生影响。未来的研究应监测 CF 患者中 SCCmecA 型的分布和毒力。
