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Abstract
Aim: To describe colonisation patterns of Staphylococcus aureus (S. aureus) and Streptococcus pyogenes (S. pyogenes) among pre-school children in New Zealand.
Method: Anterior nasal, oropharyngeal, and antecubital fossa swabs were collected from a diverse sample of 139 New Zealand children aged 4 years. Swabs were cultured for S. aureus and S. pyogenes. S. aureus isolates were tested for antibiotic susceptibility.
Results: S. aureus colonisation was more prevalent than S. pyogenes colonisation; 54% of the children were colonised with S. aureus whereas only 16% were colonised with S. pyogenes, at one or more sampling sites (P<0.0001).
S. aureus was present in a larger proportion of swabs obtained from the anterior nasal (39%, P<0.0001) or oropharynx (32%, P=0.0002) than from the antecubital fossa (14%). S. pyogenes was present in a larger proportion of swabs obtained from the oropharynx (16%) than either the anterior nasal (4%, P=0.001) or the antecubital fossa (2%, P<0.0001).
Conclusion: S. aureus and S. pyogenes are prevalent at superficial sites in preschool children in NZ, with S. aureus colonisation more prevalent than S. pyogenes colonisation. Colonisation frequency varies by site for both pathogens; S. aureus is more prevalent in the anterior nares and oropharynx while S. pyogenes is more prevalent in the oropharynx.
New Zealand (NZ) children suffer a significant and increasing burden of serious skin infection.1-4 Between 1990-91 and 2010 the annual hospitalisation rates for serious skin infection in the 0 to 14 year age group increased from 1.4 to 8.2 per 1000.5
There is marked disparity in skin infection hospitalisation rates between children of different ethnic and socioeconomic groups in NZ. From 2006 to 2010 the annual hospitalisation rates for serious skin infections for children 0 to 14 years were four times higher for Pacific, and three times higher for Maori compared with European children;5 and four times greater for children living in the most socioeconomically deprived quintile of households compared with children living in the least socioeconomically deprived quintile of households.5
Hospital admission rates for serious skin infections for children <17 years old are three times greater in NZ than in the United States (US).6,7 This larger disease burden becomes evident in early childhood; children <1 year old are nine times more likely to be admitted for skin and...