Frequent MRSA nasal colonization among hospitalized children and their parents in Angola and São Tomé and Príncipe.
BACKGROUND
The prevalence of nosocomial meticillin-resistant Staphylococcus aureus (MRSA) was previously estimated as 23% in a paediatric hospital in Luanda, Angola and 18% in a general hospital in São Tomé and Príncipe.


AIM
To evaluate the prevalence of S. aureus/MRSA colonization among hospitalized children and their parents at two hospitals in Angola and São Tomé and Príncipe.


METHODS
In 2017, 127 hospitalized children and 129 of their parents had nasal swabs for S. aureus/MRSA carriage in the two countries. The isolates were tested for the presence of the mecA and Panton-Valentine leukocidin (PVL) genes, and characterized by pulsed-field gel electrophoresis (PFGE), spa typing, multi-locus sequence typing and SCCmec typing.


FINDINGS
Twenty of 127 children (15.7%) and 13 of 129 parents (10.1%) were MRSA nasal carriers. Three lineages comprised 88% of the MRSA isolates: (i) PFGE A-ST5-SCCmec IVa (N=15; 45%), associated with spa type t105, recovered in Angola alone; (ii) PFGE N-ST8-IV/V (N=7; 21%), associated with spa types t008/t121, recovered in São Tomé and Príncipe alone; and (iii) PFGE B-ST88-IVa (N=7; 21%), associated with spa types t325/t786, present in both countries. Fifteen child/guardian pairs were colonized with identical MRSA (N=8) or meticillin-susceptible S. aureus (N=7) strains. PVL was detected in 25% of isolates, including two MRSA (ST30-V and ST8-IVa).


CONCLUSION
Hospitalized children and their parents are important reservoirs of MRSA. Infection control measures should focus on parents in order to minimize the spread of MRSA to the community.
['Rodrigues|S|S|', 'Conceição|T|T|', 'Silva|I Santos|IS|', 'de Lencastre|H|H|', 'Aires-de-Sousa|M|M|']
D000810:Angola D002353:Carrier State D002648:Child D002675:Child, Preschool D016521:Electrophoresis, Gel, Pulsed-Field D005260:Female D005838:Genotype D006761:Hospitals D006801:Humans D007297:Inpatients D008297:Male D055624:Methicillin-Resistant Staphylococcus aureus D058885:Multilocus Sequence Typing D010290:Parents D015995:Prevalence D000073136:Sao Tome and Principe D013203:Staphylococcal Infections D037521:Virulence Factors
MRSA Children Parents Angola São Tomé and Príncipe Africa Nasal carriage