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Journal of Clinical Microbiology, December 2003, p. 5718-5725, Vol. 41, No. 12
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.12.5718-5725.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Determinants of Acquisition and Carriage of Staphylococcus aureus in Infancy

Sharon J. Peacock,1* Anita Justice,1 D. Griffiths,1 G. D. I. de Silva,1,2 M. N. Kantzanou,1 Derrick Crook,1 Karen Sleeman,2 and Nicholas P. J. Day3

Nuffield Department of Clinical Laboratory Sciences,1 Department of Pediatrics,2 Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, United Kingdom3

Received 2 May 2003/ Returned for modification 22 July 2003/ Accepted 29 July 2003

Nasal carriage of Staphylococcus aureus is a major risk factor for invasive S. aureus disease. The aim of this study was to define factors associated with carriage. We conducted a prospective, longitudinal community-based study of infants and their mothers for a period of 6 months following delivery. The epidemiology of carriage was examined for 100 infant-mother pairs. Infant carriage varied significantly with age, falling from 40 to 50% during the first 8 weeks to 21% by 6 months. Determinants of infant S. aureus carriage included maternal carriage, breastfeeding, and number of siblings. Bacterial typing of S. aureus was performed by pulsed-field gel electrophoresis and multilocus sequence typing. The majority of individuals carried a single strain of S. aureus over time, and the mother was the usual source for colonizing isolates in infants. The effect of other components of the normal nasal flora on the development of S. aureus carriage was examined in 157 consecutive infants. Negative associations (putative bacterial interference) between S. aureus and other species occurred early in infancy but were not sustained. An increasing antistaphylococcal effect observed over time was not attributable to bacterial interference. S. aureus carriage in infants is likely to be determined by a combination of host, environmental, and bacterial factors, but bacterial interference does not appear to be an ultimate determinant of carrier status.

* Corresponding author. Present address: Wellcome Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand. Phone: 66 2 354 9172. Fax: 66 2 354 9169. E-mail: sharon{at}tropmedres.ac.

Journal of Clinical Microbiology, December 2003, p. 5718-5725, Vol. 41, No. 12
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.12.5718-5725.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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