Top

European Journal of Clinical Microbiology & Infectious Diseases

Published in:

01-10-2018 | Original Article

Staphylococcus aureus colonisation and its relationship with skin and soft tissue infection in New Zealand children

Authors: Mark R. Hobbs, Cameron C. Grant, Mark G. Thomas, Sarah Berry, Susan M. B. Morton, Emma Marks, Stephen R. Ritchie

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 10/2018

Abstract

New Zealand children suffer from high rates of skin and soft tissue infection (SSTI). Staphylococcus aureus colonisation is known to increase the risk of nosocomial infection. We aimed to determine whether S. aureus colonisation also increased the risk of community-onset SSTI. This study, performed within the Growing Up in New Zealand cohort, used interview and administrative data, and bacterial culture results from the nose, throat, and skin swabs collected at 4½ years of age. Multivariable log-binomial regression was used to derive adjusted risk ratios. S. aureus was isolated from 2225/5126 (43.4%) children. SSTI affected 1509/5126 (29.4%) children before age five. S. aureus colonisation at any site was associated with SSTI (aRR = 1.09, 95%CI 1.01–1.19), particularly in the year prior to swab collection (aRR = 1.18, 95%CI 1.02–1.37). The strongest association was between skin colonisation and SSTI within the year prior to swab collection (aRR = 1.47, 95%CI 1.14–1.84). Socioeconomic and ethnic variables remained independent determinants of SSTI. S. aureus colonisation was associated with an increased risk of community-onset SSTI. Socioeconomic and ethnic factors and eczema had independent effects on SSTI risk. Interventions which reduce the prevalence of S. aureus colonisation may be expected to reduce the incidence of community-onset SSTI.

Available only for authorised users

Williamson DA, Ritchie SR, Roberts SA, Coombs GW, Thomas MG, Hannaford O, Baker MG, Lennon D, Fraser JD (2014) Clinical and molecular epidemiology of community-onset invasive Staphylococcus aureus infection in New Zealand children. Epidemiol Infect:1–9. https://doi.org/10.1017/s0950268814000053

Craig E, Adams J, Oben G, Reddington A, Wicken A, Simpson J, Service obotNCaYE (2012) Te Ohonga Ake The Health Status of Māori Children and Young People in New Zealand

O’Sullivan CE, Baker MG, Zhang J (2011) Increasing hospitalizations for serious skin infections in New Zealand children, 1990-2007. Epidemiol Infect 139(11):1794–1804. https://doi.org/10.1017/s0950268810002761 CrossRefPubMed

Ritchie SR, Fraser JD, Libby E, Morris AJ, Rainey PB, Thomas MG (2011) Demographic variation in community-based MRSA skin and soft tissue infection in Auckland, New Zealand. N Z Med J 124(1332):21–30PubMed

Kluytmans J, van Belkum A, Verbrugh H (1997) Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 10(3):505–520PubMedPubMedCentral

Ritchie SR, Isdale E, Priest P, Rainey PB, Thomas MG (2015) The turnover of strains in intermittent and persistent nasal carriers of Staphylococcus aureus. J Infect. https://doi.org/10.1016/j.jinf.2015.12.010

Sollid JUE, Furberg AS, Hanssen AM, Johannessen M (2014) Staphylococcus aureus: determinants of human carriage. Infect Genet Evol 21:531–541. https://doi.org/10.1016/j.meegid.2013.03.020 CrossRefPubMed

Lebon A, Labout JA, Verbrugh HA, Jaddoe VW, Hofman A, van Wamel W, Moll HA, van Belkum A (2008) Dynamics and determinants of Staphylococcus aureus carriage in infancy: the Generation R Study. J Clin Microbiol 46(10):3517–3521. https://doi.org/10.1128/jcm.00641-08 CrossRefPubMedPubMedCentral

Harrison LM, Morris JA, Telford DR, Brown SM, Jones K (1999) The nasopharyngeal bacterial flora in infancy: effects of age, gender, season, viral upper respiratory tract infection and sleeping position. FEMS Immunol Med Microbiol 25(1–2):19–28. https://doi.org/10.1111/j.1574-695X.1999.tb01323.x CrossRefPubMed

10.

van Belkum A, Verkaik Nelianne J, de Vogel CP, Boelens Hélène A, Verveer J, Nouwen Jan L, Verbrugh Henri A, Wertheim Heiman FL (2009) Reclassification of Staphylococcus aureus nasal carriage types. J Infect Dis 199(12):1820–1826. https://doi.org/10.1086/599119 CrossRefPubMed

11.

Verhoeven PO, Grattard F, Carricajo A, Lucht F, Cazorla C, Garraud O, Pozzetto B, Berthelot P (2012) An algorithm based on one or two nasal samples is accurate to identify persistent nasal carriers of Staphylococcus aureus. Clin Microbiol Infect 18(6):551–557. https://doi.org/10.1111/j.1469-0691.2011.03611.x CrossRefPubMed

12.

Johnson RC, Ellis MW, Lanier JB, Schlett CD, Cui T, Merrell DS (2015) Correlation between nasal microbiome composition and remote purulent skin and soft tissue infections. Infect Immun 83(2):802–811. https://doi.org/10.1128/iai.02664-14 CrossRefPubMedPubMedCentral

13.

Nurjadi D, Lependu J, Kremsner PG, Zanger P (2012) Staphylococcus aureus throat carriage is associated with ABO−/secretor status. J Infect 65(4):310–317. https://doi.org/10.1016/j.jinf.2012.05.011 CrossRefPubMed

14.

Zanger P, Nurjadi D, Vath B, Kremsner PG (2011) Persistent nasal carriage of Staphylococcus aureus is associated with deficient induction of human beta-defensin 3 after sterile wounding of healthy skin in vivo. Infect Immun 79(7):2658–2662. https://doi.org/10.1128/iai.00101-11 CrossRefPubMedPubMedCentral

15.

Nakatsuji T, Chen TH, Narala S, Chun KA, Two AM, Yun T, Shafiq F, Kotol PF, Bouslimani A, Melnik AV, Latif H, Kim J-N, Lockhart A, Artis K, David G, Taylor P, Streib J, Dorrestein PC, Grier A, Gill SR, Zengler K, Hata TR, Leung DYM, Gallo RL (2017) Antimicrobials from human skin commensal bacteria protect against <em>Staphylococcus aureus</em> and are deficient in atopic dermatitis. Sci Transl Med 9 (378). https://doi.org/10.1126/scitranslmed.aah4680

16.

Verhoeven PO, Gagnaire J, Botelho-Nevers E, Grattard F, Carricajo A, Lucht F, Pozzetto B, Berthelot P (2014) Detection and clinical relevance of Staphylococcus aureus nasal carriage: an update. Expert Rev Anti-Infect Ther 12(1):75–89. https://doi.org/10.1586/14787210.2014.859985 CrossRefPubMed

17.

Nouwen JL, Fieren MW, Snijders S, Verbrugh HA, van Belkum A (2005) Persistent (not intermittent) nasal carriage of Staphylococcus aureus is the determinant of CPD-related infections. Kidney Int 67(3):1084–1092. https://doi.org/10.1111/j.1523-1755.2005.00174.x CrossRefPubMed

18.

Morton SMB, Grant CC, Atatoa Carr PE, Robinson EM, Kinloch JM, Fleming CJ, Kingi TKR, Perese LM, Liang R (2012) How do you recruit and retain a prebirth cohort? Lessons learnt from growing up in New Zealand. Eval Health Prof 1–23. https://doi.org/10.1177/0163278712462717

19.

Morton S, Ramke J, Kinloch J, Grant C, Atatoa Carr P, Leeson H, Lee A, Robinson E (2015) Growing up in New Zealand cohort alignment with all New Zealand births. Aust N Z J Public Health 39(1):82–87CrossRefPubMed

20.

Morton SMB, Atatoa Carr PE, Grant CC, Robinson EM, Bandara DK, Bird A, Ivory VC, Kingi TKR, Liang R, Marks EJ, Perese LM, Peterson ER, Pryor JE, Reese E, Schmidt JM, Waldie KE, Wall C (2013) Cohort profile: growing up in New Zealand. Int J Epidemiol 42(1):65–75. https://doi.org/10.1093/ije/dyr206 CrossRefPubMed

21.

Salmond C, Crampton P, King P, Waldegrave C (2014) NZiDep an index of socioeconomic deprivation for individuals. University of Otago, Wellington

22.

World Health Organisation (2015) ICD-10 version:2015. World Health Organisation, Geneva

23.

O'Sullivan CE, Baker MG (2010) Proposed epidemiological case definition for serious skin infection in children. J Paediatr Child Health 46(4):176–183. https://doi.org/10.1111/j.1440-1754.2009.01658.x CrossRefPubMed

24.

Baker MG, Barnard LT, Kvalsvig A, Verrall A, Zhang J, Keall M, Wilson N, Wall T, Howden-Chapman P (2012) Increasing incidence of serious infectious diseases and inequalities in New Zealand: a national epidemiological study. Lancet 379(9821):1112–1119CrossRefPubMed

25.

Miller LG, Eisenberg DF, Liu H, Chang CL, Wang Y, Luthra R, Wallace A, Fang C, Singer J, Suaya JA (2015) Incidence of skin and soft tissue infections in ambulatory and inpatient settings, 2005-2010. BMC Infect Dis 15:362. https://doi.org/10.1186/s12879-015-1071-0 CrossRefPubMedPubMedCentral

26.

Carville KS, Lehmann D, Hall G, Moore H, Richmond P, de Klerk N, Burgner D (2007) Infection is the major component of the disease burden in aboriginal and non-aboriginal Australian children: a population-based study. Pediatr Infect Dis J 26(3):210–216. https://doi.org/10.1097/1001.inf.0000254148.0000209831.0000254147f CrossRefPubMed

27.

Williamson DA, Ritchie SR, Lennon D, Roberts SA, Stewart J, Thomas MG, Baker MG (2013) Increasing incidence and sociodemographic variation in community-onset Staphylococcus aureus skin and soft tissue infections in New Zealand children. Pediatr Infect Dis J 32(8):923–925. https://doi.org/10.1097/INF.0b013e3182905f3d CrossRefPubMed

28.

Craig E, Adams J, Oben G, Reddington A, Wicken A, Simpson J (2011) The health status of children and young people in the Northern District health boards. University of Otago, NZ Child and Youth Epidemiology Service

29.

Simpson J, Duncanson M, Oben G, Adams J, Wicken A, Pierson M, Lilley R, Gallagher S (2017) Te Ohonga Ake the health of Māori children and young people in New Zealand series two. New Zealand Child and Youth Epidemiology Service, University of Otago, Dunedin

30.

O'Sullivan C, Baker MG (2012) Skin infections in children in a New Zealand primary care setting: exploring beneath the tip of the iceberg. N Z Med J 125(1351):70–79PubMed

31.

O'Sullivan C, Baker MG, Zhang J, Davies A, Cramp G (2012) The epidemiology of serious skin infections in New Zealand children: comparing the Tairawhiti region with national trends. N Z Med J 125(1351):40–54PubMed

32.

Reid P, Robson B (2007) Understanding health inequities. In: Robson B, Harris R (eds) Hauora: Maori standards of health IV. A study of the years 2000–2005. Te Ropu Rangahau Hauora a Eru Pomare, School of Medicine and Health Sciences, University of Otago, Wellington

33.

Mertz D, Frei R, Jaussi B, Tietz A, Stebler C, Fluckiger U, Widmer AF (2007) Throat swabs are necessary to reliably detect carriers of Staphylococcus aureus. Clin Infect Dis 45(4):475–477. https://doi.org/10.1086/520016 CrossRefPubMed

34.

Blumental S, Deplano A, Jourdain S, De Mendonça R, Hallin M, Nonhoff C, Rottiers S, Vergison A, Denis O (2013) Dynamic pattern and genotypic diversity of Staphylococcus aureus nasopharyngeal carriage in healthy pre-school children. J Antimicrob Chemother 68(7):1517–1523. https://doi.org/10.1093/jac/dkt080 CrossRefPubMed

35.

Munckhof WJ, Nimmo GR, Schooneveldt JM, Schlebusch S, Stephens AJ, Williams G, Huygens F, Giffard P (2009) Nasal carriage of Staphylococcus aureus, including community-associated methicillin-resistant strains, in Queensland adults. Clin Microbiol Infect 15(2):149–155. https://doi.org/10.1111/j.1469-0691.2008.02652.x CrossRefPubMed

36.

Cole AM, Tahk S, Oren A, Yoshioka D, Kim Y-H, Park A, Ganz T (2001) Determinants of Staphylococcus aureus nasal carriage. Clin Diagn Lab Immunol 8(6):1064–1069. https://doi.org/10.1128/cdli.8.6.1064-1069.2001 CrossRefPubMedPubMedCentral

37.

Shukla SK, Rose W, Schrodi SJ (2015) Complex host genetic susceptibility to Staphylococcus aureus infections. Trends Microbiol 23(9):529–536. https://doi.org/10.1016/j.tim.2015.05.008 CrossRefPubMed

Title: Staphylococcus aureus colonisation and its relationship with skin and soft tissue infection in New Zealand children
Authors: Mark R. Hobbs
Cameron C. Grant
Mark G. Thomas
Sarah Berry
Susan M. B. Morton
Emma Marks
Stephen R. Ritchie
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 10/2018
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-018-3336-1

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Staphylococcus aureus colonisation and its relationship with skin and soft tissue infection in New Zealand children

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2018

Ceftibuten plus amoxicillin-clavulanic acid for oral treatment of urinary tract infections with ESBL producing E. coli and K. pneumoniae: a retrospective observational case-series

Campylobacter jejuni virulence genes and immune-inflammatory biomarkers association with growth impairment in children from Northeastern Brazil

Evaluation of IVD 3.0 Vitek MS matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of Mycobacterium tuberculosis and nontuberculous mycobacteria and its use in routine diagnostics

Efficient processing of MRSA screening specimens by a modified inoculation protocol

The chemokine CXCL13 in cerebrospinal fluid in children with Lyme neuroborreliosis

Should we expand the indications for the DAIR (debridement, antibiotic therapy, and implant retention) procedure for Staphylococcus aureus prosthetic joint infections? A multicenter retrospective study

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page