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

  • T. Weinke
  • R. Schiller
  • F. J. Fehrenbach
  • H. D. Pohle

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.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Jacobson MA, Gellermann H, Chambers H Staphylococcus aureus bacteremia and recurrent staphylococcal infection in patients with acquired immunodeficiency syndrome and AIDS-related complex. American Journal of Medicine 1988, 85: 172–176.PubMedGoogle Scholar
  2. 2.
    Witt DJ, Craven DE, McCabe WR Bacterial infections in adult patients with the acquired immune deficiency syndrome (AIDS) and AIDS-related complex. American Journal of Medicine 1987, 82: 900–906.CrossRefPubMedGoogle Scholar
  3. 3.
    Whimbey E, Gold JWM, Polsky B, Dryjanski J, Hawkins C, Blevins A, Brannon P, Kiehn TE, Brown AE, Armstrong D Bacteremia and fungemia in patients with the acquired immunodeficiency syndrome. Annals of Internal Medicine 1986, 104: 511–514.PubMedGoogle Scholar
  4. 4.
    Luzar MA, Coles GA, Faller B, Slingeneyer A, Dah GD, Briat C, Wone C, Knefati Y, Kessler M, Peluso F Staphylococcus aureus nasal carriage and infection in patients on continuous ambulatory peritoneal dialysis. New England Journal of Medicine 1990, 322: 505–509.PubMedGoogle Scholar
  5. 5.
    Davies SJ, Ogg CS, Cameron JS, Poston S, Noble WC Staphylococcus aureus nasal carriage, exit-site infection and catheter loss in patients treated with continuous ambulatory peritoneal dialysis. Peritoneal Dialysis International 1989, 9: 61–64.PubMedGoogle Scholar
  6. 6.
    Yu VL, Goetz A, Wagener M, Smith PB, Rihs JD, Hanchett J, Zuravleff JJ Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. New England Journal of Medicine 1986, 315: 91–96.PubMedGoogle Scholar
  7. 7.
    Ganesh R, Castle D, McGibbon D, Phillips I, Bradbeer C Staphylococcal carriage and HIV infection. Lancet 1989, ii: 558.CrossRefGoogle Scholar
  8. 8.
    Lane HC, Masur H, Edgar LC, Whalen G, Rook AH, Fauci AS Abnormalities of B-cell activation and immunoregulation in patients with the acquired immunodeficiency syndrome. New England Journal of Medicine 1983, 309: 453–458.PubMedGoogle Scholar
  9. 9.
    Ellis M, Gupta S, Galant S, Hakim S, VandeVen C, Toy C, Cairo MS Impaired neutrophil function in patients with AIDS or AIDS-related complex: a comprehensive evaluation. Journal of Infectious Diseases 1988, 158: 1268–1276.PubMedGoogle Scholar
  10. 10.
    Horsburgh CR Mycobacterium avium complex infection in the acquired immunodeficiency syndrome. New England Journal of Medicine 1991, 324: 1332–1338.PubMedGoogle Scholar
  11. 11.
    Pignatari A, Pfaller M, Hollis R, Sesso R, Leme I, Herwaldt L Staphylococcus aureus colonization and infection in patients on continuous ambulatory peritoneal dialysis. Journal of Clinical Microbiology 1990, 28: 1898–1902.PubMedGoogle Scholar
  12. 12.
    Sheagren JN Staphylococcus aureus. The persistent pathogen. New England Journal of Medicine 1984, 310: 1368–1373.PubMedGoogle Scholar
  13. 13.
    Tuazon CU, Perez A, Kishaba T, Sheagren JN Staphylococcus aureus among insulin-injecting diabetic patients. An increased carrier rate. Journal of the American Medical Association 1975, 231: 1272.CrossRefPubMedGoogle Scholar
  14. 14.
    Chow JW, Yu VL Staphylococcus aureus nasal carriage in hemodialysis patients. Its role in infection and approaches to prophylaxis. Archives of Internal Medicine 1989, 149: 1258–1262.CrossRefPubMedGoogle Scholar
  15. 15.
    Bryan CS, Wilson RS, Meade P, Sill LG Topical antibiotic ointments for staphylococcal nasal carriers: survey of current practices and comparison of bacitracin and vancomycin ointments. Infection Control 1980, 1: 153–156.PubMedGoogle Scholar
  16. 16.
    Williams JD, Waltho CA, Ayliffe GA, Lowbury EJ Trials of five antibacterial creams in the control of nasal carriage ofStaphylococcus aureus. Antimicrobial Agents and Chemotherapy 1975, 7: 294–297.PubMedGoogle Scholar
  17. 17.
    Reagan DR, Doebbeling BN, Pfaller MA, Sheetz CT, Houston AK, Hollis RJ, Wenzel RP Elimination of coincidentStaphylococcus aureus nasal and hand carriage with intranasal application of mupirocin calcium ointment. Annals of Internal Medicine 1991, 114: 101–106.PubMedGoogle Scholar
  18. 18.
    Boelaert JR, DeSmedt RA, DeBaere YA, Godard CA, Matthys EG, Schurgers ML, Daneels RF, Gordts BZ, VanLanduyt HW The influence of calcium mupirocin nasal ointment on the incidence ofStaphylococcus aureus infections in haemodialysis patients. Nephrology, Dialysis, Transplantation 1989, 4: 278–281.Google Scholar
  19. 19.
    Hill RLR, Duckworth GJ, Casewell MW Elimination of nasal carriage of methicillin-resistantStaphylococcus aureus with mupirocin during a hospital outbreak. Journal of Antimicrobial Chemotherapy 1988, 22: 377–384.PubMedGoogle Scholar

Copyright information

© Friedr. Vieweg & Sohn Verlagsgesellschaft mbH 1992

Authors and Affiliations

  • T. Weinke
    • 1
    • 2
  • R. Schiller
    • 3
  • F. J. Fehrenbach
    • 3
  • H. D. Pohle
    • 1
  1. 1.II. Medizinische Klinik, Universitätsklinikum Rudolf Virchow/WeddingFreie UniversitätBerlinGermany
  2. 2.Medizinische Klinik, Klinikum SteglitzFreie Universität BerlinBerlin 45Germany
  3. 3.Abteilung fur Medizinische MikrobiologieRobert-Koch-InstitutBerlinGermany

Personalised recommendations