Increasing Prevalence of Nasal and Rectal Colonization With Methicillin-Resistant Staphylococcus aureus in Children With Cancer

Background Infections with methicillin resistant Staphylococcus aureus (MRSA) in community settings especially with strains carrying the Panton V-dentine Leukocidin (PVL) genes have increased markedly in recent years Colonization with S aureus is a risk factor for infection However, there are few studies that examine colonization and infection with PVL positive strains of MRSA in cancer patients Procedure The epidemiology of colonization and infection with MRSA was studied in children with cancer during two time periods 2000/2001 and 2006/2007 PVL genes were screened and spa typing performed on the isolates Results The prevalence of colonization with MRSA increased from 0 6% in 2000/2001 to 2 9% in 2006/2007 (P = 0 0003) MRSA colonization at admission was associated with infection (P < 0 0001 RR 38 32, 95% Cl 23 36-62 84) The prevalence of infection increased from 0 9951, in 2000/2001 to 3 78% in 2006-2007 (P = 0 0002) Of the 32 colonized patients 18 (56%) had infection None of the 14 colonized but non infected patients had dual colonization of nares and rectum while 8 of the 18 infected patients had colonization of both of these sites (P = 0 004) Ten patients (31%) were colonized with PVL positive strains Patients colonized with PVL positive strains were more likely to be colonized both in the nares and rectum (P = 0 005) and more likely to have infection (P = 0 001) Recurrent MRSA infections were seen in 22% of patients Conclusion An increasing prevalence of colonization with MRSA was observed in children with cancer at our institution Colonization with MRSA especially with PVL positive strains was associated with infection Pediatr Blood Cancer 2010 55 1317 1322 (C) 2010 Wiley Liss Inc