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Title: Carriage of staphylococcus aureus in family units
Authors: Boost, MV
O'Donoghue, MM 
Choy, FP
Lo, C
Issue Date: 2004
Source: 14th European Congress of Clinical Microbiology & Infectious Diseases, Prague, Czech Republic, May 1-4, 2004 How to cite?
Abstract: Objectives: Although numerous studies have investigated prevalence of nasal carriage of Staphylococcus aureus, and several case studies have documented spread within a family, there have been no studies of patterns of carriage in families and risk factors affecting spread in the family. This study aimed to examine family carriage of S. aureus.
Methods: One hundred families of students were invited to participate and given an information sheet and consent form. Students were instructed to collect specimens by swabbing the septum adjacent to the nasal ostium. Swabs in transport media were returned to the laboratory within 14 h for culture and isolation of S. aureus. Participants provided demographic details and information on contacts with health care, recent antibiotic use and hospitalisation. Isolates of S. aureus were screened for methicillin resistance and tested for sensitivity to eight antibiotics. Relatedness of strains was determined by pulsed-field gel electrophoresis (PFGE).
Results: A total of 92 families with 352 individuals participated in the study. Specimens were collected from 332 subjects (94%). The number of family members varied from two to eight (mean 3.8). Seventy-three (22%) subjects from 49 families carried S. aureus and there was no significant difference in carriage rates between males and females. Carriage rates were higher in larger families (greater than three members) (P <= 0.001), and in subjects who had contact with a nursing home (42.8%). Logistic regression indicated that in subjects aged>=51 years use of antibiotics in the last 4 weeks reduced risk of carriage, whilst long-term treatment increased risk. Methicillin-resistant strains were isolated from three subjects. One subject, who worked in a hospital and had been recently hospitalised, carried a multiply-resistant strain. The other two strains, one isolated from a nursing home employee, were resistant only to beta-lactams. Carriage of MRSA was significantly associated with occupation in health care. PFGE revealed multiple carriers of an identical strain within a family in 10 cases. Different strains were observed in eight families with multiple carriers.
Conclusion: Carriage of S. aureus and MRSA were 22 and 0.9%, respectively. Carriage rates were higher in large families and in elderly subjects on long term treatment. PFGE revealed transmission within the family unit. Carriage of MRSA in this community remains low and carriers failed to transmit these strains to other family members.
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