Association betweenStaphylococcus aureus nasopharyngeal colonization and septicemia in patients infected with the human immunodeficiency virus

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Abstract

In an attempt to identify risk factors forStaphylococcus aureus septicemia, 136 consecutive HIV-infected patients were investigated for the presence of nasopharyngeal colonization withStaphylococcus aureus and subsequentStaphylococcus aureus infection. Sixty of 136 (44.1 %) HIV-infected patients had staphylococci which were detected in the nasopharynx on initial culture compared to 12 of 39 (30.8 %) patients with chronic diseases and 11 of 47 (23.4 %) healthy hospital staff. Another 12 HIV-infected subjects proved to beStaphylococcus aureus carriers on follow-up cultures. Patients with full-blown AIDS had a higher carriage rate compared to subjects who were only HIV-positive (p<0.05), indicating thatStaphylococcus aureus colonized patients were more severely ill. Eight patients withStaphylococcus aureus septicemia were observed, all of whom were carriers; no septicemia occurred in the non-colonized patients (p<0.01). Colonized patients with neutropenia (< 1000/µl) were significantly more likely to develop septicemia (p<0.01). Nasopharyngeal colonization withStaphylococcus aureus and the presence of an indwelling catheter were established to be factors that help identify patients at risk of acquiring subsequentStaphylococcus aureus infection.