MRSA transmission in the community: emerging from under the radar
| Autor: | Stéphan Juergen Harbarth, Jan Kluytmans |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
ddc:616
Methicillin-Resistant Staphylococcus aureus Staphylococcus aureus business.industry Staphylococcal Infections Staphylococcal infections medicine.disease medicine.disease_cause Methicillin-resistant Staphylococcus aureus Article Microbiology law.invention Methicillin Infectious Diseases Transmission (mechanics) law Humans Medicine Prospective Studies Radar Child business |
| Zdroj: | The Lancet Infectious Diseases, Vol. 20, No 2 (2020) pp. 147-149 Lancet Infect Dis |
| ISSN: | 1473-3099 |
| Popis: | BACKGROUND: We comprehensively defined household longitudinal, strain-level Staphylococcus aureus transmission dynamics in households of children with community-associated methicillin-resistant S. aureus (CA-MRSA) skin and soft tissue infection (SSTI). METHODS: Between 2012–2015, 150 children, their household contacts, and pets were enrolled in a prospective cohort study in metropolitan Saint Louis, MO. Serial cultures to detect S. aureus were collected from three anatomic sites of household members, two dog/cat sites, and 21 environmental surfaces five times over 12 months. Molecular epidemiology of S. aureus isolates was determined via repetitive-sequence PCR. Longitudinal, multivariable generalized mixed-effects logistic regression models identified factors associated with S. aureus acquisition. FINDINGS: Household MRSA acquisitions (N=1267) were driven equally by introduction of novel strains into households (N=510) and transmissions within households (N=602; between household members, environmental surfaces, and pets), each associated with distinct factors. Participants demonstrating frequent handwashing practices were less likely to introduce novel strains into the household (odds ratio [OR] 0·86, credible interval [CrI] 0·74–1·01). Transmission recipients were less likely to own their homes (OR 0·77, CrI 0·63–0·94) and were more likely to share bedrooms with strain-colonized individuals (OR 1·33, CrI 1·12–1·58), live in homes with higher environmental S. aureus contamination burden (OR 3·97, CrI 1·96–8·20), and report interval SSTI (OR 1·32, CrI 1·07–1·64). Transmission sources were more likely to share bath towels (OR 1·25, CrI 1·01–1·57). Pets were often transmission recipients, but rarely the sole transmission source. INTERPRETATION: The household environment plays a key role in transmission, a factor associated with SSTI. Future interventions should inclusively target household members and the environment, focusing on straightforward changes in hand hygiene and sharing behaviors. FUNDING: National Institutes of Health, Agency for Healthcare Research and Quality, Children’s Discovery Institute, Burroughs Wellcome Foundation, Defense Advanced Research Projects Agency. |
| Databáze: | OpenAIRE |
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