Emergence of community-associated methicillin-resistant Staphylococcus aureus carriage in children in Cambodia |
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Authors: | Nickerson Emma K Wuthiekanun Vanaporn Kumar Varun Amornchai Premjit Wongdeethai Nattavut Chheng Kheng Chantratita Narisara Putchhat Hor Thaipadungpanit Janjira Day Nicholas P Peacock Sharon J |
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Affiliation: | Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke''s Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom |
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Abstract: | We previously described the first reported isolation of methicillin-resistant Staphylococcus aureus (MRSA) (a case series of pediatric community-associated MRSA infections) in Cambodia. We define the rate of pediatric MRSA carriage in the same population and characterize the associated bacterial genotypes by using pulsed-field gel electrophoresis and multilocus sequence typing. A prospective cohort study of MRSA carriage conducted over one month at the Angkor Hospital for Children, Siem Reap, Cambodia, identified MRSA carriage in 87 (3.5%) of 2,485 children who came to the outpatient department, and 6 (4.1%) of 145 inpatients, including at least two with cases of nosocomial acquisition. Genotyping of all 93 MRSA isolates resolved 5 genotypes. Most (91%) isolates were assigned to sequence type 834. Only 28 (32%) of 87 MRSA carriers identified in the outpatient department had no history of recent healthcare contact. The study findings have important implications for healthcare in a setting where diagnostic microbiology and access to antimicrobial drugs with efficacy against MRSA are limited. |
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