RESUMO

Staphylococcus aureus nasal colonization is a major risk factor for infection. Studies have suggested an epidemiologic shift in the methicillin-resistant S. aureus (MRSA) strains that circulate in Brazil. We conducted cross-sectional studies of MRSA carriage among 1) children and adolescents in community daycare centers, 2) an outpatient clinic, and 3) hospitals in a large Brazilian metropolitan setting. There were 1.500 study subjects, 500 from each locale: 768 (51.2%) carried S. aureus whereas 150 (10%) of these were colonized with MRSA. The most common lineages were the Southwest Pacific (SWP) and the Pediatric clones in all three groups. Roughly 50% of SWP carried Panton-Valentine leukocidin (PVL) (p < 0.01) genes while 63.3% of the Pediatric clones were resistant or intermediately resistant to erythromycin (p < 0.01). This study describes a clonal change of the Brazilian epidemic clone (BEC) to the Pediatric and SWP lineages in Brazil. This finding has implications for clinical management of MRSA infections.

Assuntos

Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/genética , Instituições de Assistência Ambulatorial , Antibacterianos/farmacologia , Toxinas Bacterianas/genética , Brasil/epidemiologia , Portador Sadio , Criança , Creches , Pré-Escolar , Cidades/epidemiologia , Estudos Transversais , Exotoxinas/genética , Feminino , Genótipo , Hospitais Públicos , Humanos , Lactente , Leucocidinas/genética , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Mucosa Nasal/microbiologia , Prevalência , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/isolamento & purificação