AUTHOR=Tsai Ming-Han , Chiu Chih-Yung , Su Kuan-Wen , Liao Sui-Ling , Shih Hsiang-Ju , Hua Man-Chin , Yao Tsung-Chieh , Lai Shen-Hao , Yeh Kuo-Wei , Chen Li-Chen , Huang Jing-Long
TITLE=Community-Associated Methicillin-Resistant Staphylococcus Aureus Colonization in a Birth Cohort of Early Childhood: The Role of Maternal Carriage
JOURNAL=Frontiers in Medicine
VOLUME=8
YEAR=2021
URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.738724
DOI=10.3389/fmed.2021.738724
ISSN=2296-858X
ABSTRACT=Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization in infants may pose a risk for subsequent infection in children. The study aimed to determine S. aureus colonization patterns in infancy, and strain relatedness between maternal and infant colonization.
Methods: A prospective cohort study was conducted for nasopharyngeal S. aureus detection in neonates at delivery; in children at 1, 6, 12, 24, 36, and 60 months of age; and from mothers immediately after the delivery of their baby and when their child is 1 month old. A questionnaire for infants and mothers was administered at each planned visit.
Results: In total, 521 and 135 infant–mother dyads underwent nasopharyngeal swab collection at 1 month and immediately after delivery, respectively. Among the 521 dyads at 1 month of age, concordant S. aureus colonization was found in 95 dyads, including MRSA in 48.4% (46/95). No concordant MRSA carriage was present among the 135 dyads at delivery. The genetic relatedness of concurrent MRSA-colonized dyads showed that more than two-thirds (32/46 [69.6%]) had identical genotypes, mainly ST 59/PVL-negative/SCCmec IV. Infants aged 1 month had the highest incidence of S. aureus, and the trend declined to a nadir at the age of 12 months. Carrier mothers who smoked cigarettes may increase the risk of infant Staphylococcus colonization (odds ratio, 2.12; 95% confidence interval, 1.23–3.66; p < 0.01).
Conclusions: Maternal–infant horizontal transmission may be the primary source of MRSA acquisition in early infancy. The avoidance of passive smoking could be recommended for the prevention of S. aureus carriage.