Skip to main content
    • Aa
    • Aa

Epidemiology of Methicillin-Resistant Staphylococcus aureus in a University Medical Center Day Care Facility

  • Angela L. Hewlett (a1) (a2) (a3), Pamela S. Falk (a1), Katrina S. Hughes (a2) (a4) and C. Glen Mayhall (a1) (a2) (a3)

Few data are available on methicillin-resistant Staphylococcus aureus (MRSA) colonization in day care. We performed a study in a medical university child care center to study the epidemiology of MRSA in this population.




A child care center on the campus of a university medical center.


One hundred four children who attended the child care center and 32 employees gave samples that were cultured for MRSA. Seventeen household members of the children and employee found to be colonized with MRSA also gave samples that were cultured. Parents and employees completed questionnaires about demographic characteristics, medical conditions and treatments, and possible exposure risks outside the child care center. In addition, 195 environmental samples were taken from sites at the childcare center. Isolates were analyzed for relatedness by use of molecular typing, and statistical analysis was performed.


The prevalence of MRSA in the children was 6.7%. One employee (3.1%) was colonized with MRSA. Cultures of samples given by 6 of 17 (35.3%) family members of these children and the employee yielded MRSA. MRSA was recovered from 4 of 195 environmental samples. Molecular typing revealed that many of the MRSA isolates were indistinguishable, and 18 of the 21 isolates were community-associated MRSA. Multivariable analysis revealed that receipt of macrolide antibiotics (P = .002; odds ratio, 39.6 [95% confidence interval, 3.4—651.4]) and receipt of asthma medications (P = .024; odds ratio, 26.9 [95% confidence interval, 1.5-500.7]) were related to MRSA colonization.


There was a low prevalence of MRSA colonization in children and employees in the child care center but a higher prevalence of colonization in their families. Molecular typing showed that transmission of MRSA likely occurred in the child care center. The use of macrolide antibiotics and asthma medications may increase the risk of MRSA colonization in this population.

Corresponding author
University of Texas Medical Branch, 301 University Boulevard, Route 0770, Galveston, TX 77555-0770 (
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. BC Herold , LC Immergluck , MC Marahan , et al.Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA 1998;279:593598.

2. EJ Gorak , SM Yamada , JD Brown . Community-acquired methicillin-resistant Staphylococcus aureus in hospitalized adults and children without known risk factors. Clin Infect Dis 1999;29:797800.

3. MM Nakamura , KL Rohling , M Shashaty , H Lu , Y-W Tang , KM Edwards . Prevalence of methicillin-resistant Staphylococcus aureus nasal carnage in the community pediatric population. Pediatr Infect Dis J 2002;21:917921.

4. AH Suggs , MC Maranan , S Boyle-Vavra , RS Daum . Methicillin-resistant and borderline methicillin-resistant asymptomatic Staphylococcus aureus colonization in children without identifiable risk factors. Pediatr Infect Dis J 1999;18:410414.

5. CB Creech II, DS Kernodle , A Alsentzer , C Wilson , KM Edwards . Increasing rates of nasal carriage of methicillin-resistant Staphylococcus aureus in healthy children. Pediatr Infect Dis J 2005;24:617621.

7. M Eveillard , Y Martin , N Hidri , Y Boussougant , M-L Joly-Guillou . Carriage of methicillin-resistant Staphylococcus aureus among hospital employees: prevalence, duration, and transmission to households. Infect Control Hosp Epidemiol 2004;25:114120.

8. RM Klevens , MA Morrison , SK Fridkin , et al.Community-associated methicillin-resistant Staphylococcus aureus and healthcare risk factors. Emerg Infect Dis 2006;12:19911993.

10. PM Adcock , P Pastor , F Medley , JE Patterson , TV Murphy . Methicillin-resistant Staphylococcus aureus in two child care centers. J Infect Dis 1998;178:577580.

11. R Shahin , IL Johnson , F Jamieson , A McGeer , J Tolkin , EL Ford-Jones . Methicillin-resistant Staphylococcus aureus carriage in a child care center following a case of disease. Arch Pediatr Adolesc Med 1999;153:864868.

12. H Wertheim , HA Verbrugh , C van Pelt , P de Man , A van Belkum , MC Vos . Improved detection of methicillin-resistant Staphylococcus aureus using phenyl mannitol broth containing aztreonam and ceftizoxime. J Clin Microbiol 2001;39:26602662.

13. DC Oliveira , H de Lencastre . Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2002;46:21552161.

14. C Milheirico , DC Oliveira , H de Lencastre . Multiplex PCR strategy for subtyping the staphylococcal cassette chromosome mec type IV in methicillin-resistant Staphylococcus aureus: SCCmec IV multiplex. J Antimicrob Chemother 2007;60:4248.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 1 *
Loading metrics...

Abstract views

Total abstract views: 54 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 21st August 2017. This data will be updated every 24 hours.