The role of Staphylococcus aureus carriage in the pathogenesis of bloodstream infectionReport as inadecuate




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BMC Research Notes

, 7:428

Infectious Diseases

Abstract

BackgroundStaphylococcus aureus SA colonisation is associated with development of bloodstream infection BSI, with the majority of colonising and infecting strains identical by pulsed-field gel electrophoresis PFGE. We examined SA colonisation in patients with SABSI to delineate better the relationship between the two.

MethodsPatients with SABSI were swabbed in the nose, throat, groin, axilla and rectum. Isolates were typed using PFGE. Logistic regression was performed to determine factors associated with positive swabs.

Results79 patients with SABSI had swabs taken. 46 58% had ≥ 1 screening swab positive for S. aureus; of these 37 80% were in the nose, 11 24% in the throat, 12 26% in the groin, 11 24% in the axilla and 8 17% in the rectum. On multivariate analysis, days from blood culture to screening swabs OR 0.5, 95% CI 0.32-0.78, P = 0.003 and methicillin resistance OR 9.5, 95% CI 1.07-84.73, P = 0.04 were associated with having positive swabs. Of 46 participants who had a blood sample and 1 other sample subtyped, 33 72%, 95% CI 57-84% had all identical subtypes, 1 2% had subtypes varying by 1–3 bands and 12 26% had subtypes ≥ 3 bands different. 30-36 83% blood-nose pairs were identical.

ConclusionOverall, 58% of patients with SABSI had positive screening swabs. Of these, only 80% had a positive nose swab ie less than half 37-79, 47% of all SABSI patients were nasally colonised. This may explain why nasal mupirocin alone has not been effective in preventing SA infection. Measures to eradicate non-nasal carriage should also be included.

KeywordsStaphylococcus aureus Blood stream infection Colonisation Electronic supplementary materialThe online version of this article doi:10.1186-1756-0500-7-428 contains supplementary material, which is available to authorized users.

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Author: Caroline Marshall - Emma McBryde

Source: https://link.springer.com/







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