• Pediatric Infection and Vaccine
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• v.17 no.1
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• pp.9-15
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• 2010

Purpose : This study was performed to investigate the prevalence of Staphylococcus aureus (S. aureus) nasal carriage in Korean children attending day care centers. Methods : During September and October 2009, a survey for nasal carriage of S. aureus and methicillin-resistant S. aureus (MRSA) was conducted among children attending day care centers located in Seoul with questionnaire survey for evaluation of risk factors of acquisition of MRSA was obtained from their guardians. A culture of the anterior nares swabs using enrichment broth was executed for isolating S. aureus and oxacillin susceptibility was assessed by the disk diffusion method. Results : Out of the 428 children enrolled whose mean age was 55 months old, 163 (38.1%) were colonized with S. aureus. Of the 163 isolates, 40 (24.5%) were MRSA. The nasal carriage rate of S. aureus showed an increasing trend with increase of age. Based on the answer to the questionnaire, 9.2% and 3.6% of children had a recent history of hospitalization and surgery, respectively, and approximately 40% of children had a history of prescription of antibiotics within 1 year prior to enrollment. Of the 428 subjects, 40 (9.3%) were MRSA nasal carriers. Conclusion : S. aureus and MRSA carriage rate of children attending day care center in Korea was 38.1% and 9.3%, respectively. Continued surveillance for nasal carriage rate of S. aureus and MRSA (especially community-associated MRSA) is mandatory.

• Pediatric Infection and Vaccine
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• v.18 no.2
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• pp.143-153
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• 2011

Purpose : It is known that carriage rates of Staphylococcus aureus (S. aureus) are highest in newborns and that the asymptomatic carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with invasive MRSA infection with the colonizing strain. This study was carried out to investigate the carriage rates of MRSA in neonates with neonatal jaundice. Methods : We reviewed the medical records of 545 neonates admitted with neonatal jaundice to neonatal intensive care units between January 2006 and December 2010. Nasal and inguinal swab specimens had been taken from them and cultured for the isolation of S. aureus. Antimicrobial susceptibility tests had been done for such isolates to determine methicillinresistance. Results : Out of 545 neonates, 318 (58.3%) were colonized with S. aureus and 214 (39.3%) were colonized with MRSA. Results of the antibiogram analysis showed that 65.7% of MRSA isolates were likely to be community-associated (CA) MRSA. Conclusion : Based on the MRSA carriage rate of 39.3%, a surveillance program for MRSA colonization is considered necessary in neonates transferred from other clinics or hospitals. Out of MRSA isolates, 65.7% were likely to be CA-MRSA. This suggests that CA-MRSA strains were already present in obstetric clinic environments where the neonates were born. It is thought that MRSA surveillance programs in these environments are also necessary.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.536-541
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• 2013

Background Pathogens in the nasal cavity during nasal surgery could lead to a systemic infectious condition, such as bacteremia, nosocomial infection, or toxic shock syndrome. However, there is no research about the prevalence of nasal carriage in patients with nasal bone fracture. Methods This was a prospective, double-blind, randomized study about the rate of nasal carriage in 200 patients with nasal bone fracture in Korea. Nasal secretions were taken from both the middle nasal meatus and colonized. All analyses were carried out using SPSS software. Results Pathogens were identified in 178 of the 200 cases. Coagulase-negative staphylococci (CNS) were the most cultured bacteria in 127 (66.84%) of the 190 total patients after excluding 10 cases of contaminated samples, and methicillin-resistant coagulase-negative staphylococci (MRCNS) were found in 48 (25.26%). Staphylococcus aureus was the second most identified pathogen, found in 36 (18.95%), followed by 7 cases (3.68%) of methicillin-resistant Staphylococcus aureus (MRSA). The prevalence rate of MRSA in the females was higher than that in the males (RR=4.70; 95% CI, 1.09-20.18), but other demographic factors had no effect on the prevalence rate of MRSA and MRCNS. Conclusions The prevalence rate of these pathogens in patients with nasal bone fracture in Korea was similar to other reports. However, few studies have addressed the prevalence rate of CNS and MRCNS in accordance with risk factors or the change in prevalence according to specific prophylaxis against infectious complications. Additional research is needed on the potential connections between clinical factors and microbiological data.

• Biomedical Science Letters
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• v.10 no.3
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• pp.309-315
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• 2004

Methicillin resistant Staphylococcus aureus (MRSA) is one of the most common nosocomial pathogens. Many hospitals are facing the problems which they have to use expensive antibiotics and suffer from long term hospital study of patients due to MRSA. This study is to survey MRSA nasal colonization of patients and doctors, and to investigate the mode of transmission of MRSA by pulsed field gel electrophoresis (PFGE) and then use these data to prevent further spread of cross infection and reduce nosocomial infection. Subjects of this study were 201 patients with MRSA infection at an university hospital in Busan from Sept. 1997 to Aug. 1998. Bacterial genotypes of MRSA strains isolated from nares and wound of patients (14 cases) and nares of doctors (8 cases) were analyzed by PFGE. Nasal cultures of 20 I patients for detecting nasal colonization of MRSA were performed and incidence rate of nasal colonization was 40％ (80/201). Among 201 patients MRSA were acquired from hospital in 140 (70％) patients and were acquired from community 61 (30％) patients. Among 14 pairs of MRSA from colonized or infected sites and anterior nares, DNA patterns of 10 pairs (71.4％) were equal. 86％ (12/14) MRSA strains isolated from patients and 12.5％ (1/8) MRSA strains isolated from doctors show same pattern. DNA patterns were changed in some doctors after nasal oint. Treatment. It could be inferred that the most sources of MRSA in hospital are the endemically existing MRSA. Therefore, we believe that it would be necessary to control MRSA nasal colonization of the patients and the related medical teams to reduce the medical cost and to improve the efficacy of medical cares.

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.131-141
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• 2009

Purpose : In February 2007, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections occurred in two newborns in the neonatal unit of Sahmyook Seoul Hospital. We performed this study to investigate the characteristics of MRSA nasal carriage among neonatal unit staffs and the effective infection control measures. Methods : Nasal swab specimens were obtained from the neonatal unit staff for the presence of MRSA. MRSA-colonized staffs were offered decolonization therapy with oral trimethoprim-sulfamethoxazole or 2% mupirocin ointment. Every 2-4months after decolonizaton, repeat nasal swab specimens were obtained. Also, samples from the neonatal unit environment and room air were collected. Results : Successful decolonization was achieved in 92% of the cases in 2 weeks after decolonization therapy, but most of the staffs were recolonized after several months. The nature of antibiotic susceptibility was changed from multi-drugsusceptible to multi-drug-resistant. The most frequently contaminated objects were dressing carts, computer keyboards, bassinets and washbowls. In environmental cultures using the settle microbe count method, the colony counts were decreased significantly at the last study period compared with the first study period in the neonatal room, breastfeeding room, service room, and dressing room (P <0.05). Conclusion : Effective control of sustained MRSA transmission within an institution may require prompt identification, treatment, and monitoring of colonized and/or infected staffs. However, nasal decolonization therapy may induce multi-drugresistant MRSA infection and had no effect on decreasing the MRSA nasal carriage rate in our study. Other factors might be more important, such as improving staff education, increasing hand hygiene practices, and environmental sterilization for controlling MRSA infections.

• Korean Journal of Veterinary Research
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• v.39 no.2
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• pp.383-389
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• 1999

A randomized experimental study was done to evaluate short course therapeutic efficacies of two types of mupirocin ointment (Bactroban Nasal and Bactroban) in the elimination of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization (16 dogs) and wound infection (3 dogs or 18 wound sites) in dogs. In each model, dogs being assigned to TR-1 treatment group was given ointment twice a day for two consecutive days, and those that assigned to TR-2 treatment group was given the same dose for three days. Neither TR-1 nor TR-2 regimen was effective to clear nasal carriage completely with a clearing rate of 62.5% and 87.5%, respectively. Whereas, for 2 days at least twice daily application of mupirocin for wound infection was quite enough to eliminate MRSA, with a clearing rate of 83.3~100% by 4 weeks follow-up. No apparent side effects were observed in each model, and in no case was it necessary to discontinue the treatment. Further controlled studies on the elimination of nasal colonization are required to establish cost-effective and efficient regimen on companion animals.

• Journal of Environmental Health Sciences
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• v.19 no.1
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• pp.71-76
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• 1993

Nasal carrige of Staphylococcus was studied in relation to its significance as a source of the Staphylococci that caused hospital-acquired infection. Due to the trend of the increasing r esistance of S. aureus to many antimicrobial agents, it is necessary to study the sensitivity to antibiotics of this infectious microorganisms. 50 persons from general hospital and 50 college students were the object of this study. The following results were obtained 3 0 Strains of S. aureus were isolated. The rate of S. aureus nasal carrying were 26% in college students and 34% in hospital personnel. S. aureus which showed resistance to penicillin were 90%, tetracyclin 43%, erythromycin 37% and oxacillin 17%. The number of penicillin resistance of S. aureus were 11 (84%) in college students and 16 (94%) in hospital personnel. The number of strains of penicillin resistant S. aureus which produced 13-1actamase were 9 (82%) in college student and 14 (88%) in hospital personnel. Methicillin-resistant S. aureus (MRSA) which showed resistance to erythromycin and penicillin G were 100%, tetracyline, cephalothin and clindamycin were over 40% respectively, gentamicin 20%, SAM 20% and chloramphenicol 0%.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.24-32
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• 2003

Purpose : Nosocomial infection with Staphylococcus aureus, especially methicillin resistant S. aureus, has become a serious concern in the neonatal intensive care unit. The aim of this study is to investigate the virulence factors, and the relationship between the antibiotic resistance and the associated genes of Staphylococcus aureus isolated from nasal cavity of neonates. Methods : Fifty one isolates of S. aureus were obtained from nasal swab taken in 28 neonates in the NICU and nursery of Pusan National University Hospital between February and May, 2001. They were tested in regard to antibiotic susceptibility, coagulase test and typing, plasmid DNA profile, as well as reactivity to enterotoxin A-E(sea, seb, sec, sed, see) genes and toxic shock syndrome toxin-1(tst) gene by polymerase chain reaction(PCR). Associated genes such as mecA, mecR1, mecI, and femA were also determined by PCR. The origin of MRSA strains was assessed using DNA fingerprinting by arbitrarily-primed polymerase chain reaction(AP-PCR). Results : Twenty three(45.1%) and six(11.8%) isolates were resistant to oxacillin and vancomycin respectively. Multidrug resistance to three or more of the antibiotics tested was observed in 51.0% of the isolates. Forty two isolates were coagulase positive and twenty two isolates had mecA gene. Sixteen isolates had both mecA and femA genes and had type I-III plasmids. 64.7% of isolates carried sec gene, and 80.4% carried tst gene. DNA fingerprinting by AP-PCR for 12 MRSA strains showed 10 distinct patterns, suggesting different origins. Conclusion : We confirmed that the prevalence of nasal carriage of S. aureus and the incidence of antimicrobial-resistant S. aureus, especially vancomycin resistance, is very high in neonates who were admitted in NICU and nursery. It is possible that these pathogens are responsible for serious nosocomial infections in neonates. The need for improved surveillance and continuous control of pathogens is emphasized.