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Epidemiology of Methicillin-Resistant Staphylococcus aureus in a University Medical Center Day Care Facility

Published online by Cambridge University Press:  02 January 2015

Angela L. Hewlett ,
Pamela S. Falk ,
Katrina S. Hughes  and
C. Glen Mayhall
Angela L. Hewlett*
Affiliation:
Department of Healthcare Epidemiology, University of Texas Medical Branch, Galveston, Texas Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas
Pamela S. Falk
Affiliation:
Department of Healthcare Epidemiology, University of Texas Medical Branch, Galveston, Texas
Katrina S. Hughes
Affiliation:
Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
C. Glen Mayhall
Affiliation:
Department of Healthcare Epidemiology, University of Texas Medical Branch, Galveston, Texas Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas
*
University of Texas Medical Branch, 301 University Boulevard, Route 0770, Galveston, TX 77555-0770 (alhewlet@gmail.com)
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Abstract

Objective.

Few data are available on methicillin-resistant Staphylococcus aureus (MRSA) colonization in day care. We performed a study in a medical university child care center to study the epidemiology of MRSA in this population.

Design.

Survey.

Setting.

A child care center on the campus of a university medical center.

Methods.

One hundred four children who attended the child care center and 32 employees gave samples that were cultured for MRSA. Seventeen household members of the children and employee found to be colonized with MRSA also gave samples that were cultured. Parents and employees completed questionnaires about demographic characteristics, medical conditions and treatments, and possible exposure risks outside the child care center. In addition, 195 environmental samples were taken from sites at the childcare center. Isolates were analyzed for relatedness by use of molecular typing, and statistical analysis was performed.

Results.

The prevalence of MRSA in the children was 6.7%. One employee (3.1%) was colonized with MRSA. Cultures of samples given by 6 of 17 (35.3%) family members of these children and the employee yielded MRSA. MRSA was recovered from 4 of 195 environmental samples. Molecular typing revealed that many of the MRSA isolates were indistinguishable, and 18 of the 21 isolates were community-associated MRSA. Multivariable analysis revealed that receipt of macrolide antibiotics (P = .002; odds ratio, 39.6 [95% confidence interval, 3.4—651.4]) and receipt of asthma medications (P = .024; odds ratio, 26.9 [95% confidence interval, 1.5-500.7]) were related to MRSA colonization.

Conclusions.

There was a low prevalence of MRSA colonization in children and employees in the child care center but a higher prevalence of colonization in their families. Molecular typing showed that transmission of MRSA likely occurred in the child care center. The use of macrolide antibiotics and asthma medications may increase the risk of MRSA colonization in this population.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 10 , October 2009 , pp. 985 - 992
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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