BMC Infectious Diseases (May 2019)

Differences in gram-positive bacterial colonization and antimicrobial resistance among children in a high income inequality setting

  • Felipe Piedade Gonçalves Neves,
  • Mariel Asbury Marlow,
  • Gabriel Rezende-Pereira,
  • Marcos Gabriel Pinheiro,
  • Allyne Fandino Martinez dos Santos,
  • Maria de Fátima Nogueira de Freitas,
  • Rosana Rocha Barros,
  • Fábio Aguiar-Alves,
  • Claudete Aparecida Araújo Cardoso,
  • Lee Woodland Riley

DOI
https://doi.org/10.1186/s12879-019-4104-2
Journal volume & issue
Vol. 19, no. 1
pp. 1 – 9

Abstract

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Abstract Background 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. Methods 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. Results 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. Conclusions 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.

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