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Pediatría (Asunción)
versão On-line ISSN 1683-9803
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CATALDO RUSSOMANDO, Karina et al. Carriage of Multidrug-resistant Staphylococcus aureus in the Oral Cavities of Children Presenting for Treatment at a Dental Clinic in Paraguay. Pediatr. (Asunción) [online]. 2014, vol.41, n.3, pp.201-207. ISSN 1683-9803.
Introduction: Staphylococcus aureus is a bacterium with special characteristics of virulence and resistance to the antibiotics used in clinical practice, and whose spread presents a significant public health challenge. Objective: To identify the presence of S. aureus colonizing the oral cavities of children presenting for treatment at a dental clinic in Asunción, Paraguay and determine its sensitivity or resistance to antibiotics. Materials and Methods: We conducted a descriptive observational study of children aged 2-15 years from August to September 2013. Swab samples from oral cavities were taken and cultivated in mannitol salt agar. Isolates from S. aureus were tested for susceptibility to 11 antibiotics and molecular methods were used to identify the presence of the mecA gene and Panton-Valentine leukocidin (PVL) virulence factor. A questionnaire was used to identify socio-demographic and risk factors associated with S. aureus infection. Results: The study included 112 children. S. aureus was isolated in 37 swab samples (33%), and resistance to at least one antibiotic was found in 94.6% (35) of these. Resistance was found to penicillin in 89%, chloramphenicol in 16.2%, oxacillin in 10.8%, erythromycin in 8%, clindamycin in 8%, gentamicin in 5.4%, and 1 isolate (2.7%) was identified with intermediate resistance to ciprofloxacin. Multiple-drug resistance was found in 4 isolates containing the mecA gene. No sample with the PVL virulence factor was detected. Conclusion: The high prevalence of multidrug-resistant S. aureus in children with no risk factors such as prior hospitalization or antibiotic administration implies a high risk of endogenous infection as well as potential transfer of resistance determinants between microorganisms of the normal oral cavity flora.
Palavras-chave : Staphylococcus aureus; oral cavity; antibiotic resistance; mecA gene; Panton-Valentine leukocidin.