Frontiers in Medicine (Oct 2021)

Community-Associated Methicillin-Resistant Staphylococcus Aureus Colonization in a Birth Cohort of Early Childhood: The Role of Maternal Carriage

  • Ming-Han Tsai,
  • Ming-Han Tsai,
  • Ming-Han Tsai,
  • Chih-Yung Chiu,
  • Chih-Yung Chiu,
  • Kuan-Wen Su,
  • Kuan-Wen Su,
  • Sui-Ling Liao,
  • Sui-Ling Liao,
  • Hsiang-Ju Shih,
  • Man-Chin Hua,
  • Man-Chin Hua,
  • Tsung-Chieh Yao,
  • Tsung-Chieh Yao,
  • Shen-Hao Lai,
  • Shen-Hao Lai,
  • Kuo-Wei Yeh,
  • Kuo-Wei Yeh,
  • Li-Chen Chen,
  • Li-Chen Chen,
  • Jing-Long Huang,
  • Jing-Long Huang

DOI
https://doi.org/10.3389/fmed.2021.738724
Journal volume & issue
Vol. 8

Abstract

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Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization in infants may pose a risk for subsequent infection in children. The study aimed to determine S. aureus colonization patterns in infancy, and strain relatedness between maternal and infant colonization.Methods: A prospective cohort study was conducted for nasopharyngeal S. aureus detection in neonates at delivery; in children at 1, 6, 12, 24, 36, and 60 months of age; and from mothers immediately after the delivery of their baby and when their child is 1 month old. A questionnaire for infants and mothers was administered at each planned visit.Results: In total, 521 and 135 infant–mother dyads underwent nasopharyngeal swab collection at 1 month and immediately after delivery, respectively. Among the 521 dyads at 1 month of age, concordant S. aureus colonization was found in 95 dyads, including MRSA in 48.4% (46/95). No concordant MRSA carriage was present among the 135 dyads at delivery. The genetic relatedness of concurrent MRSA-colonized dyads showed that more than two-thirds (32/46 [69.6%]) had identical genotypes, mainly ST 59/PVL-negative/SCCmec IV. Infants aged 1 month had the highest incidence of S. aureus, and the trend declined to a nadir at the age of 12 months. Carrier mothers who smoked cigarettes may increase the risk of infant Staphylococcus colonization (odds ratio, 2.12; 95% confidence interval, 1.23–3.66; p < 0.01).Conclusions: Maternal–infant horizontal transmission may be the primary source of MRSA acquisition in early infancy. The avoidance of passive smoking could be recommended for the prevention of S. aureus carriage.

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