Importance of colonization site in the current epidemic of staphylococcal skin abscesses

Howard Faden, Alan J. Lesse, Jennifer Trask, January A. Hill, Donavon J. Hess, Diane Dryja, Yi Horng Lee

Research output: Contribution to journalArticlepeer-review

43 Scopus citations

Abstract

OBJECTIVE: The goal was to compare rectal and nasal Staphylococcus aureus colonization rates and S aureus pulsed-field types (PFTs) for children with S aureus skin and soft-tissue abscesses and normal control subjects. METHODS: Sixty consecutive children with S aureus skin and softtissue abscesses that required surgical drainage and 90 control subjects were enrolled. Cultures of the nares and rectum were taken in both groups. S aureus isolates from all sites were characterized through multiple-locus, variable-number, tandem-repeat analysis, pulsed-field gel electrophoresis, staphylococcal cassette chromosome mec typing for methicillin-resistant S aureus isolates, and determination of the presence of Panton-Valentine leukocidin genes. RESULTS: S aureus was detected significantly more often in the rectum of children with abscesses (47%) compared with those in the control group (1%; P = .0001). Rates of nasal colonization with S aureus were equivalent for children with abscesses (27%) and control subjects (20%; P = .33). S aureus recovered from the rectum was identical to S aureus in the abscess in 88% of cases, compared with 75% of nasal isolates. PFT USA300, staphylococcal cassette chromosome mec type IV, and Panton-Valentine leukocidin genes were significantly increased in the S aureus isolates from children with abscesses compared with those from control subjects. CONCLUSIONS: Skin and soft-tissue abscesses in the current epidemic of community-associated staphylococcal disease are strongly associated with rectal colonization by PFT USA300. Nasal colonization in children does not seem to be a risk factor.

Original languageEnglish (US)
Pages (from-to)e618-e624
JournalPediatrics
Volume125
Issue number3
DOIs
StatePublished - Mar 1 2010

Keywords

  • Abscess
  • Community-acquired MRSA
  • Staphylococcal infections

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