Risk Factors for Recurrent Colonization With Methicillin-Resistant Staphylococcus aureus in Community-Dwelling Adults and Children

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Cluzet, Valerie C. ; Gerber, Jeffrey S. ; Nachamkin, Irving ; Metlay, Joshua P. ; Zaoutis, Theoklis E. ; Davis, Meghan F. ; Julian, Kathleen G. ; Linkin, Darren R. ; Coffin, Susan E. ; Margolis, David J. ; Hollander, Judd E. ; Bilker, Warren B. ; Han, Xiaoyan ; Mistry, Rakesh D. ; Gavin, Laurence J. ; Tolomeo, Pam ; Wise, Jacqueleen A. ; Wheeler, Mary K. ; Hu, Baofeng ; Fishman, Neil O. ; Royer, David ; Lautenbach, Ebbing
• Corporate Authors:
  Prevention Epicenters Network of the Centers for Disease Control and Prevention (CDC)
• Description:
  OBJECTIVE.
  
  To identify risk factors for recurrent methicillin-resistant Staphylococcus aureus (MRSA) colonization.
  
  DESIGN.
  
  Prospective cohort study conducted from January 1, 2010, through December 31, 2012.
  
  SETTING.
  
  Five adult and pediatric academic medical centers.
  
  PARTICIPANTS.
  
  Subjects (ie, index cases) who presented with acute community-onset MRSA skin and soft-tissue infection.
  
  METHODS.
  
  Index cases and all household members performed self-sampling for MRSA colonization every 2 weeks for 6 months. Clearance of colonization was defined as 2 consecutive sampling periods with negative surveillance cultures. Recurrent colonization was defined as any positive MRSA surveillance culture after clearance. Index cases with recurrent MRSA colonization were compared with those without recurrence on the basis of antibiotic exposure, household demographic characteristics, and presence of MRSA colonization in household members.
  
  RESULTS.
  
  The study cohort comprised 195 index cases; recurrent MRSA colonization occurred in 85 (43.6%). Median time to recurrence was 53 days (interquartile range, 36–84 days). Treatment with clindamycin was associated with lower risk of recurrence (odds ratio, 0.52; 95% CI, 0.29–0.93). Higher percentage of household members younger than 18 was associated with increased risk of recurrence (odds ratio, 1.01; 95% CI, 1.00–1.02). The association between MRSA colonization in household members and recurrent colonization in index cases did not reach statistical significance in primary analyses.
  
  CONCLUSION.
  
  A large proportion of patients initially presenting with MRSA skin and soft-tissue infection will have recurrent colonization after clearance. The reduced rate of recurrent colonization associated with clindamycin may indicate a unique role for this antibiotic in the treatment of such infection.
  
  
• Subjects:
  Adolescent Adult Anti-Bacterial Agents Carrier State Child Child, Preschool Clindamycin Family Characteristics Female Humans Male Methicillin-Resistant Staphylococcus Aureus Prospective Studies Recurrence Risk Factors Skin Diseases, Bacterial Soft Tissue Infections Staphylococcal Infections Young Adult

  More +
• Source:
  Infect Control Hosp Epidemiol. 36(7):786-793
• Pubmed ID:
  25869756
• Pubmed Central ID:
  PMC9859687
• Document Type:
  Journal Article
• Funding:
  K24 AI080942/AI/NIAID NIH HHSUnited States/ ; U54CK000163/ACL/ACL HHSUnited States/ ; U54-CK000163/CK/NCEZID CDC HHSUnited States/ ; K24-AI080942/AI/NIAID NIH HHSUnited States/
• Volume:
  36
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:759337c10cf70278e037d4032fba4beec6797095fa697bbeae2bd8550ef14313
• Download URL:
  https://stacks.cdc.gov/view/cdc/123838/cdc_123838_DS1.pdf
• File Type:
  [PDF - 440.71 KB ]