Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brazil.
School of Public Health, University of California, Berkeley, CA, USA.
BMC Infect Dis. 2019 May 29;19(1):478. doi: 10.1186/s12879-019-4104-2.
Staphylococcus aureus and beta-hemolytic streptococci (BHS) diseases disproportionately affect populations in middle/low-income countries. To assess if this disparity is reflected in colonization by these organisms, we compared their colonization frequency among children from different socioeconomic status (SES) communities in a city with high income inequality.
Between May-August 2014, we collected nasal and throat swabs to investigate S. aureus and BHS colonization among children who attended private and public pediatric clinics. Patients were classified as high SES, middle/low SES, and slum residents. We investigated the antimicrobial resistance profile, the SCCmec types and the presence of PVL genes among methicillin-resistant S. aureus (MRSA). We also examined the antimicrobial resistance profile and serogroups of BHS.
Of 598 children, 221 (37%) were colonized with S. aureus, of which 49 (22%) were MRSA. MRSA colonization was higher in middle/low SES (n = 18; 14%) compared with high SES (n = 17; 6%) and slum (n = 14; 8%) residents (p = 0.01). All MRSA strains were susceptible to clindamycin, nitrofurantoin, and rifampin. The highest non-susceptibility frequency (42.9%) was observed to erythromycin. SCCmec type V was only found in isolates from high SES children; types I and II were found only in middle/low SES children. Ten (20%) MRSA isolates carried PVL genes. Twenty-four (4%) children were BHS carriers. All BHS (n = 8) found in high SES children and six (67%) isolates from slum patients belonged to group A. All group B streptococci were from middle/low SES children, corresponding to five (71%) of the seven BHS isolated in this group. BHS isolates were susceptible to all drugs tested.
Children from different SES communities had distinct bacterial colonization profiles, including MRSA carriage. Public health officials/researchers should consider SES when assessing disease transmission and control measures.
金黄色葡萄球菌和β-溶血性链球菌（BHS）疾病在中/低收入国家的人群中发病率不成比例。为了评估这种差异是否反映在这些生物体的定植中，我们比较了在一个高收入不平等城市中来自不同社会经济地位（SES）社区的儿童的定植频率。
在 2014 年 5 月至 8 月期间，我们收集了鼻腔和咽喉拭子，以调查在私人和公共儿科诊所就诊的儿童中金黄色葡萄球菌和 BHS 的定植情况。患者被分为高 SES、中/低 SES 和贫民窟居民。我们调查了耐甲氧西林金黄色葡萄球菌（MRSA）的抗生素耐药谱、SCCmec 类型和 PVL 基因的存在。我们还检查了 BHS 的抗生素耐药谱和血清型。
在 598 名儿童中，有 221 名（37%）定植了金黄色葡萄球菌，其中 49 名（22%）是 MRSA。中/低 SES（n=18；14%）儿童的 MRSA 定植率高于高 SES（n=17；6%）和贫民窟（n=14；8%）居民（p=0.01）。所有 MRSA 菌株均对克林霉素、呋喃妥因和利福平敏感。红霉素的非敏感性频率最高（42.9%）。SCCmec 类型 V 仅在高 SES 儿童的分离株中发现；类型 I 和 II 仅在中/低 SES 儿童的分离株中发现。10 株（20%）MRSA 分离株携带 PVL 基因。24 名（4%）儿童为 BHS 携带者。在高 SES 儿童中发现的所有 BHS（n=8）和贫民窟患者的 6 株（67%）分离株均属于 A 群。所有 B 群链球菌均来自中/低 SES 儿童，其中 7 株 BHS 中有 5 株（71%）属于该组。BHS 分离株对所有测试药物均敏感。
来自不同 SES 社区的儿童具有不同的细菌定植谱，包括 MRSA 定植。公共卫生官员/研究人员在评估疾病传播和控制措施时应考虑 SES。
