A community-based study on nasal carriage of Staphylococcus aureus among healthy schoolchildren and its antimicrobial susceptibility pattern

BACKGROUND: Invasive infections from Staphylococcus aureus are increasingly being encountered in healthy children. Nasal colonization of S. aureus is associated with increased risk for acquiring invasive disease. The objective of this study was to determine the prevalence and risk factors for S. aureus nasal colonization among a healthy pediatric population and to determine antibiotic susceptibilities of the S. aureus isolates. MATERIALS AND METHODS: Using a cross-sectional study design, a total of 468 children of age group 5–16 years from 15 different schools of urban Belgaum (Belagavi) located under Ramnagar Urban Health Centre of KLE University's Jawaharlal Nehru Medical College, India, were screened for S. aureus colonization. Information on selected risk factors for nasal colonization of S. aureus was obtained through a questionnaire. Samples were obtained from the anterior nares and processed. S. aureus isolates were confirmed by growth on selective media and coagulase testing. Disc diffusion antibiotic susceptibility tests were performed according to the Clinical and Laboratory Standard Institute guidelines. RESULTS: Of the 468 children included in the study, S. aureus was isolated from the anterior nares in 142 (30.3%) children. S. aureus isolates exhibited resistance to multiple classes of antibiotics including co-trimoxazole resistance (19.7%), ciprofloxacin (47.9%), erythromycin resistance (33.1%), clindamycin resistance (4.9%), amoxiclav (1.4%), and linezolid (4.9%). CONCLUSION: Children in India have a high rate of nasal colonization of S. aureus. The high rate of resistance to many classes of antibiotics among S. aureus strains is of great concern warranting continued surveillance and antimicrobial stewardship