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Nasal microbiota predictors for methicillin resistant Staphylococcus colonization in critically ill children

Kathleen Zani1, Joseph Hobeika2, Yilun Sun3

  • 1Department of Pediatrics, Division of Critical Care, University of Tennessee Health Science Center, Memphis, TN, United States of America.

Plos One
|January 15, 2025
PubMed
Abstract

Insights

Specific nasal bacteria may predict methicillin-resistant Staphylococcus colonization in pediatric intensive care units. This finding could improve early detection and prevention strategies for these resistant infections.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pediatric Critical Care

Background:

  • Current methicillin-resistant Staphylococcus aureus (MRSA) surveillance in pediatric intensive care units (PICUs) is limited and resource-intensive.
  • It fails to detect other methicillin-resistant Staphylococcus species, necessitating improved detection methods.

Purpose of the Study:

  • To determine the prevalence of methicillin-resistant Staphylococcus colonization upon PICU admission.
  • To identify nasal microbiome predictors of methicillin-resistant Staphylococcus colonization.

Main Methods:

  • Prospective cohort study in a 20-bed PICU (2020-2021).
  • Collected anterior nares swabs for MRSA culture, nasal microbiome analysis, and mecA+ qPCR within five days of PICU admission.
  • Calculated predictive values for methicillin-resistant Staphylococcus carriage and nasal microbiome attributes.

Main Results:

  • 5 (8.0%) of 62 patients had MRSA-positive nares cultures.
  • 22 (35.5%) of 63 patients carried methicillin-resistant Staphylococcus (MRSA or methicillin-resistant coagulase-negative Staphylococci).
  • Fever during PICU stay was associated with MRSA or MRCoNS carriage. Specific microbes (Haemophilus, Streptococcus, Prevotella, Corynebacterium) predicted methicillin-resistant Staphylococcus colonization.

Conclusions:

  • Methicillin-resistant Staphylococcus carriage poses a transmission risk in critically ill children.
  • Distinct nasal microbial communities appear to facilitate methicillin-resistant Staphylococcus colonization.

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