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Differences in gram-positive bacterial colonization and antimicrobial resistance among children in a high income
Felipe Piedade Gonçalves Neves1, Mariel Asbury Marlow2, Gabriel Rezende-Pereira3
1Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brazil. fpgneves@id.uff.br.
Insights
Socioeconomic status (SES) impacts bacterial colonization in children. Methicillin-resistant Staphylococcus aureus (MRSA) colonization was higher in middle/low SES children, highlighting disparities in infectious disease carriage.
Area of Science:
- Microbiology
- Public Health
- Epidemiology
Background:
- Staphylococcus aureus and beta-hemolytic streptococci (BHS) infections disproportionately affect low-income countries.
- Socioeconomic status (SES) may influence colonization rates of these pathogens.
Purpose of the Study:
- To compare S. aureus and BHS colonization frequencies in children across different SES groups.
- To investigate antimicrobial resistance and genetic profiles of colonizing bacteria.
Main Methods:
- Collected nasal and throat swabs from 598 children across high SES, middle/low SES, and slum communities.
- Analyzed S. aureus and BHS colonization, including methicillin-resistant S. aureus (MRSA) typing and antimicrobial susceptibility.
- Examined BHS serogroups and antimicrobial resistance.
Main Results:
- S. aureus colonization was 37%, with MRSA at 22% (49/221).
- MRSA colonization was significantly higher in middle/low SES children (14%) compared to high SES (6%) and slum (8%) residents (p=0.01).
- Distinct MRSA SCCmec types and BHS serogroups were associated with different SES groups, with BHS isolates generally susceptible to tested antibiotics.
Conclusions:
- Children from varying SES backgrounds exhibit distinct bacterial colonization patterns, including MRSA.
- SES is a critical factor for public health officials to consider in disease transmission and control strategies.
Background:
Staphylococcus aureus and beta-hemolytic streptococci (BHS) diseases disproportionately affect populations in middle/low-income countries. To assess if this disparity is reflected in colonization by these organisms, we compared their colonization frequency among children from different socioeconomic status (SES) communities in a city with high income inequality.
Methods:
Between May-August 2014, we collected nasal and throat swabs to investigate S. aureus and BHS colonization among children who attended private and public pediatric clinics. Patients were classified as high SES, middle/low SES, and slum residents. We investigated the antimicrobial resistance profile, the SCCmec types and the presence of PVL genes among methicillin-resistant S. aureus (MRSA). We also examined the antimicrobial resistance profile and serogroups of BHS.
Results:
Of 598 children, 221 (37%) were colonized with S. aureus, of which 49 (22%) were MRSA. MRSA colonization was higher in middle/low SES (n = 18; 14%) compared with high SES (n = 17; 6%) and slum (n = 14; 8%) residents (p = 0.01). All MRSA strains were susceptible to clindamycin, nitrofurantoin, and rifampin. The highest non-susceptibility frequency (42.9%) was observed to erythromycin. SCCmec type V was only found in isolates from high SES children; types I and II were found only in middle/low SES children. Ten (20%) MRSA isolates carried PVL genes. Twenty-four (4%) children were BHS carriers. All BHS (n = 8) found in high SES children and six (67%) isolates from slum patients belonged to group A. All group B streptococci were from middle/low SES children, corresponding to five (71%) of the seven BHS isolated in this group. BHS isolates were susceptible to all drugs tested.
Conclusions:
Children from different SES communities had distinct bacterial colonization profiles, including MRSA carriage. Public health officials/researchers should consider SES when assessing disease transmission and control measures.
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