Community-associated methicillin-resistant Staphylococcus aureus transmission in households of infected cases: a pooled analysis of primary data from three studies across international settings
Knox, J; Van Rijen, M; Uhlemann, A-C; Miller, M; Hafer, C; Vavagiakis, P; Shi, Q; Johnson, P D R; Coombs, G; Kluytmans-Van Den Bergh, M; Kluytmans, J; Bennett, C M; Lowy, F D
(2015) Epidemiology and Infection, volume 143, issue 2, pp. 354 - 65
(Article)
Abstract
Diverse strain types of methicillin-resistant Staphylococcus aureus (MRSA) cause infections in community settings worldwide. To examine heterogeneity of spread within households and to identify common risk factors for household transmission across settings, primary data from studies conducted in New York (USA), Breda (The Netherlands), and Melbourne (Australia) were pooled. Following
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MRSA infection of the index patient, household members completed questionnaires and provided nasal swabs. Swabs positive for S. aureus were genotyped by spa sequencing. Poisson regression with robust error variance was used to estimate prevalence odds ratios for transmission of the clinical isolate to non-index household members. Great diversity of strain types existed across studies. Despite differences between studies, the index patient being colonized with the clinical isolate at the home visit (P < 0·01) and the percent of household members aged <18 years (P < 0·01) were independently associated with transmission. Targeted decolonization strategies could be used across geographical settings to limit household MRSA transmission.
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Keywords: Adolescent, Adult, Australia, Child, Child, Preschool, Community-Acquired Infections, Family Characteristics, Female, Humans, Infant, Male, Methicillin-Resistant Staphylococcus aureus, Netherlands, New York, Retrospective Studies, Staphylococcal Infections, Young Adult, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
ISSN: 0950-2688
Publisher: Cambridge University Press
(Peer reviewed)