Genotypic distribution of Staphylococcus aureus colonizing children and adolescents in daycare centers, an outpatient clinic, and hospitals in a major Brazilian urban setting

• Published in: Diagnostic microbiology and infectious disease Vol. 97; no. 3; p. 115058
• Main Authors: Neto, Egidio Domingos André, Guerrero, Jaclyn, Snyder, Robert E., Pereira, Renata Freire Alves, de Fátima Nogueira de Freitas, Maria, Silva-Santana, Giorgio, Riley, Lee W., Aguiar-Alves, Fábio
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2020
• Subjects: Ambulatory Care Facilities; Anti-Bacterial Agents - pharmacology; Bacterial Toxins - genetics; Brazil - epidemiology; Carrier State; Child; Child Day Care Centers; Child, Preschool; Cities - epidemiology; Colonization, pediatric; Cross-Sectional Studies; Exotoxins - genetics; Female; Genotype; Hospitals, Public; Humans; Infant; Leukocidins - genetics; Male; Methicillin-Resistant Staphylococcus aureus - drug effects; Methicillin-Resistant Staphylococcus aureus - genetics; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Microbial Sensitivity Tests; MRSA; Nasal Mucosa - microbiology; Prevalence; Staphylococcal Infections - diagnosis; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcus aureus - drug effects; Staphylococcus aureus - genetics; Staphylococcus aureus - isolation & purification; USA1100; USA800; Brazil; Cities; Colonization, pediatric; USA1100; USA800; MRSA
• ISSN: 0732-8893; 1879-0070; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2020.115058

Staphylococcus aureus nasal colonization is a major risk factor for infection. Studies have suggested an epidemiologic shift in the methicillin-resistant S. aureus (MRSA) strains that circulate in Brazil. We conducted cross-sectional studies of MRSA carriage among 1) children and adolescents in community daycare centers, 2) an outpatient clinic, and 3) hospitals in a large Brazilian metropolitan setting. There were 1.500 study subjects, 500 from each locale: 768 (51.2%) carried S. aureus whereas 150 (10%) of these were colonized with MRSA. The most common lineages were the Southwest Pacific (SWP) and the Pediatric clones in all three groups. Roughly 50% of SWP carried Panton-Valentine leukocidin (PVL) (p < 0.01) genes while 63.3% of the Pediatric clones were resistant or intermediately resistant to erythromycin (p < 0.01). This study describes a clonal change of the Brazilian epidemic clone (BEC) to the Pediatric and SWP lineages in Brazil. This finding has implications for clinical management of MRSA infections.