#staphylococcus #children - household surfaces may spread resistant strains of bacteria.

The homes of many children infected with methicillin-resistant Staphylococcus aureus (MRSA) may be environments in which MRSA strains live on common household surfaces, according to an article published online September 8 in JAMA Pediatrics.

That was the case for almost half of the children with MRSA infections in a recent study, in which researchers found MRSA on bed linens, television remote controls, and bathroom hand towels. Household pets also carried MRSA strains. Dr Stephanie A. Fritz (Department of Pediatrics, Washington University School of Medicine) and colleagues conducted a study involving 50 children with active or recent (within 2 months) community-acquired MRSA infection.

Twenty-one (42%) of the children were colonized with S aureus at one or more body sites. Colonization was exclusively MRSA for 14 (28%) children, exclusively methicillin-susceptible S aureus (MSSA) for 6 (12%) children, and both MRSA and MSSA at different body sites for 1 child (2%).

The researchers conducted enrollment visits in each child's home and administered questionnaires to collect data on medical history, prior infections, hygiene practices, and household characteristics. They collected colonization cultures from the anterior nares, axillae, and inguinal folds of each participant. The researchers also obtained surface samples from 21 household items they presumed to be frequently handled by household members. They also tested household pets.

They recovered S aureus from at least one household surface for 32 (64%) of the households. They recovered a total of 23 (46%) households with MRSA contamination. MRSA was most commonly found on bed linens (18%), television remote controls (16%), and bathroom hand towels (15%). S aureus had colonized in 6 (23%) of 26 dogs tested and one (7%) of 14 cats tested. 

Of the 50 children, 20 (40%) had either a colonizing or infecting strain type that was concordant with an environmental strain recovered from a household surface. Surfaces most commonly contaminated with a concordant strain were:

• children's bed linens (8 of 41, 20%),
• television remote controls (8 of 40, 20%),
• bathroom light switches (7 of 41, 17%),
• bathroom hand towel (5 of 31, 16%), and
• bathroom sink (6 of 41, 15%).

Interestingly, surfaces commonly perceived to be contaminated (such as toilet seats and door handles) were not major reservoirs of MRSA. Therefore, these recent data can inform better prevention strategies within the household. The authors noted that frequency of cleaning was not associated with the likelihood of surface contamination. In contrast, more individuals per 1000 square feet was associated with a higher proportion of surface contamination.