Preventing community-associated methicillin and multidrug-resistant Staphylococcus aureus infections in infants and young children
BACKGROUND: Multidrug-resistant Staphylococcus aureus (MDRSA) strains, including those resistant to methicillin (MRSA), are among the most prevalent and serious pathogenic risks to children’s health throughout the world. With increasing drug resistance, treatment of Staphylococcus aureus is more difficult and the risks of treatment failure are increased, particularly for underserved populations with limited access to health care.
GAP: MDRSA, especially MRSA, used to be largely a hospital or health-care associated infection, but since 2000, most infections in the US (and many other countries) originate in the community. While the focus of much clinical attention has been on MRSA, it is becoming increasingly clear that methicillin susceptible multidrug resistant strains of Staphylococcus aureus are also contributing to morbidity and mortality in children. We do not completely understand the most important and preventable community associated risks of exposure to these dangerous pathogens, particularly for very young children. Without this knowledge we cannot develop effective education or other interventions.
HYPOTHESIS: Our overall objective is to develop the evidence base for translation into preventing exposure of infants and young children to MRSA and other multidrug resistant strains of Staphylococcus aureus. Specifically, we will test the hypothesis that indirect contact with zoonotic strains of MDRSA is an important source of MDRSA exposure for young children living in regions of intensive food animal production. This hypothesis is grounded in recent studies by us and others identifying MDRSA strains in livestock and the role of animal production as a reservoir of resistance.
METHODS: In this cross-sectional community-based study, we will enroll children below age 7 to compare those whose parents/caregivers work with livestock to children whose parents/caregivers do not work in this industry. We will obtain detailed information by parental/caregiver interview on exposures, lifestyle, and other factors that may be associated with MDRSA exposure; we will determine current exposures through analysis of nasal swabs from participating children and caregivers and at sites of infection (if present).
DISCUSSION: MDRSA strains are a global health risk for children. Our overall objective is to develop the evidence base for translation into preventing exposure of infants and young children to MRSA and other multidrug resistant strains of Staphylococcus aureus.
Animal, Antibiotics, Cross-Sectional, Drug Resistance, Environment, Human, MRSA, Staphylococcus