Skip Navigation LinksHome > August 2008 - Volume 27 - Issue 8 > Risk Factors and Molecular Analysis of Panton-Valentine Leuk...
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e31816f63b5
Original Studies

Risk Factors and Molecular Analysis of Panton-Valentine Leukocidin-Positive Methicillin-Resistant Staphylococcus aureus Colonization in Healthy Children

Lo, Wen-Tsung MD, PhD; Lin, Wei-Jen MD; Tseng, Min-Hua MD; Wang, Sheng-Ru MD; Chu, Mong-Ling MD; Wang, Chih-Chien MD, PhD

Collapse Box

Abstract

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 ≤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.

© 2008 Lippincott Williams & Wilkins, Inc.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.