A report in the June edition of JAMA’s Archives of Pediatrics & Adolescent Medicine shows that children who come into contact in the household with Staphylococcus aureus skin and soft tissue infections (SSTI) seem to have a high rate of methicillin-resistant S aureus (MRSA) colonization compared with the general population.

Background information of the cross-sectional study shows that S aureus outbreaks can occur within households with the infected household member with asymptomatic S aureus colonization becoming a source for transmitting the infection to other household members. This can include children who had already received treatment, who may be re-infected with the bacteria.

Stephanie A. Fritz, M.D., M.S.C.I., and her team from the Washington University School of Medicine in St. Louis, declare:

“In this study evaluating S aureus colonization in household contacts of pediatric patients with community-associated S aureus SSTI and colonization, we determined that more than half of household contacts were also colonized with S aureus. The prevalence of MRSA colonization (21 percent overall) among these household members was substantially higher than previously published national rates (0.8 percent-1.5 percent) for MRSA colonization in community populations.”

The team examined 183 patients with community-associated S aureus SSTI and S aureus colonization in the nose, armpit and/or groin area and their household contacts at St. Louis Children’s Hospital Emergency Department and ambulatory wound center, as well as from nine community pediatric practices affiliated with a practice-based research network. Household contacts were defined as persons who spend more than half of their time each week in the affected person’s primary household.

The findings revealed that 112 of the 183 patients or 61% were colonized with MRSA, whilst 54 patients or 30% had methicillin-sensitive S aureus (MSSA), and 17 patients, i.e. 9% had both MRSA and MSSA.

From a total of 609 household contacts, 323 people or 53% had S aureus, whilst 115 or 19% had MRSA, 195 people or 32% were infected with MSSA, and 13 people or 2% had MRSA and MSSA.

According to the results, parents above all other household contacts were more likely to be colonized with MRSA, whilst the most prominent site for MRSA colonization was the groin area.

The researchers conclude:

“Household contacts of patients with S aureus infections are not routinely sampled for S aureus colonization, and failure to identify all colonized household members may facilitate persistent colonization or recurrent infections. In addition, household environmental surfaces and shared objects represent potential reservoirs for S aureus transmission. However, there are no data to indicate whether routine household sampling or decolonization would be practical or cost-effective.”

Written By Petra Rattue