Importance of colonization site in the current epidemic of staphylococcal skin abscesses

Area of Science:

• Infectious Diseases
• Microbiology
• Epidemiology

Background:

• Community-associated Staphylococcus aureus infections, particularly skin and soft-tissue abscesses, are a growing public health concern.
• Understanding the colonization patterns and specific strains of Staphylococcus aureus is crucial for effective prevention and treatment strategies.

Purpose of the Study:

• To compare Staphylococcus aureus colonization rates and pulsed-field types (PFTs) in the rectum and nares of children with S aureus skin and soft-tissue abscesses versus healthy controls.
• To identify specific S aureus strains and genetic markers associated with abscess formation in children.

Main Methods:

• A case-control study involving 60 children with S aureus abscesses requiring surgical drainage and 90 healthy control children.
• Rectal and nasal cultures were obtained from all participants.
• S aureus isolates were characterized using pulsed-field gel electrophoresis (PFGE), staphylococcal cassette chromosome mec (SCCmec) typing for methicillin-resistant S aureus (MRSA), and Panton-Valentine leukocidin (PVL) gene detection.

Main Results:

• Staphylococcus aureus was found significantly more often in the rectum of children with abscesses (47%) compared to controls (1%; P = .0001).
• Nasal S aureus colonization rates were similar between children with abscesses (27%) and controls (20%; P = .33).
• The prevalent PFT USA300, SCCmec type IV, and PVL genes were significantly increased in S aureus isolates from children with abscesses.

Conclusions:

• Rectal colonization with Staphylococcus aureus, specifically the USA300 strain, is strongly associated with the current epidemic of community-associated skin and soft-tissue abscesses in children.
• Nasal colonization by S aureus does not appear to be a significant risk factor for developing these abscesses in pediatric populations.