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Updated: May 21, 2026

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Staphylococcus aureus colonization in children with community-associated Staphylococcus aureus skin infections and
Stephanie A Fritz1, Patrick G Hogan, Genevieve Hayek
1Department of Pediatrics, Washington University School of Medicine, 660 South Euclid Ave., St Louis, MO 63110, USA. fritz_s@kids.wustl.edu
Insights
Household contacts of children with skin infections often carry Staphylococcus aureus. Methicillin-resistant S aureus (MRSA) colonization was common, particularly in parents and the inguinal folds.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Staphylococcus aureus (S. aureus) skin and soft tissue infections (SSTIs) are common in children.
- Understanding S. aureus colonization in household contacts is crucial for infection control.
Purpose of the Study:
- To determine the prevalence of S. aureus colonization in household contacts of children with SSTIs.
- To identify risk factors for S. aureus colonization in these contacts.
- To map the anatomic sites of S. aureus colonization in both patients and their contacts.
Main Methods:
- A cross-sectional study was conducted.
- Participants included pediatric patients with S. aureus SSTI and their household contacts.
- S. aureus colonization was assessed in various body sites, including the nose, axilla, and inguinal folds.
Main Results:
- Over half (53%) of household contacts were colonized with S. aureus.
- Methicillin-resistant S. aureus (MRSA) was prevalent, colonizing 19% of contacts.
- Parents had a higher likelihood of MRSA colonization (OR, 1.72).
- The inguinal folds were a frequent site for MRSA colonization (OR, 1.67), while the nose was more commonly colonized by methicillin-sensitive S. aureus (MSSA) (OR, 1.75).
Conclusions:
- Household contacts of children with S. aureus SSTI exhibit a high rate of MRSA colonization.
- The inguinal fold represents a significant colonization site for MRSA.
- Findings suggest the importance of the inguinal fold in active surveillance programs for MRSA in healthcare settings.
Objectives:
To measure prevalence of Staphylococcus aureus colonization in household contacts of children with acute S aureus skin and soft tissue infections (SSTI), determine risk factors for S aureus colonization in household contacts, and assess anatomic sites of S aureus colonization in patients and household contacts.
Design:
Cross-sectional study.
Setting:
St Louis Children's Hospital Emergency Department and ambulatory wound center and 9 community pediatric practices affiliated with a practice-based research network.
Participants:
Patients with community-associated S aureus SSTI and S aureus colonization (in the nose, axilla, and/or inguinal folds) and their household contacts.
Outcome Measures:
Colonization of household contacts of pediatric patients with S aureus colonization and SSTI.
Results:
Of 183 index patients, 112 (61%) were colonized with methicillin-resistant S aureus (MRSA); 54 (30%), with methicillin-sensitive S aureus (MSSA); and 17 (9%), with both MRSA and MSSA. Of 609 household contacts, 323 (53%) were colonized with S aureus: 115 (19%) with MRSA, 195 (32%) with MSSA, and 13 (2%) with both. Parents were more likely than other household contacts to be colonized with MRSA (odds ratio, 1.72; 95% CI, 1.12 to 2.63). Methicillin-resistant S aureus colonized the inguinal folds more frequently than MSSA (odds ratio, 1.67; 95% CI, 1.16 to 2.41), and MSSA colonized the nose more frequently than MRSA (odds ratio, 1.75; 95% CI, 1.19 to 2.56).
Conclusions:
Household contacts of children with S aureus SSTI had a high rate of MRSA colonization compared with the general population. The inguinal fold is a prominent site of MRSA colonization, which may be an important consideration for active surveillance programs in hospitals.
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