Skip to main content

Advertisement

Log in

Staphylococcus aureus carriage and health care-acquired infection

  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

Staphylococcus aureus is one of the most common nosocomial pathogens. Its propensity to establish prolonged carriage among hospitalized patients and increasing resistance to antibiotics makes control of this organism within the hospital difficult. High-level vancomycin resistance has now been reported in a single clinical isolate of S. aureus, emphasizing the need to increase efforts to control nosocomial spread. Knowledge of the epidemiology of S. aureus colonization among patients has shed new light on the potential difficulties in interrupting nosocomial transmission. Effective control of S. aureus within the hospital and community will require more aggressive measures that include earlier diagnosis of colonized patients, better handwashing and barrier precaution measures, and renewed efforts to eradicate the carriage state.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Diekema DJ, Pfaller MA, Schmitz FJ, et al.: Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997–1999. Clin Infect Dis 2001, 32(Suppl 2):S114-S132.

    Article  PubMed  CAS  Google Scholar 

  2. Sievert DM, Boulton ML, Stoltman G, et al.: Staphylococcus aureus resistant to vancomycin. MMWR 2002, 51:565–567.

    Google Scholar 

  3. Martin MA: Methicillin-resistant Staphylococcus aureus: the persistent resistant nosocomial pathogen. Curr Clin Top Infect Dis 1994, 14:170–191.

    PubMed  CAS  Google Scholar 

  4. Williams R: Healthy carriage of Staphylococcus aureus: it’s prevalence and importance. Bacteriol Rev 1963, 27:56–71.

    PubMed  CAS  Google Scholar 

  5. Hayakawa T, Hayashidera T, Yoneda K, et al.: Preferential pharyngeal colonization of methicillin resistant Staphylococcus aureus in infants. J Pediatr 1999, 134:252.

    PubMed  CAS  Google Scholar 

  6. Rimland D, Roberson B: Gastrointestinal carriage of methicillin-resistant Staphylococcus aureus. J Clin Microbiol 1986, 24:137–138.

    PubMed  CAS  Google Scholar 

  7. Linnemann CCJr, Staneck JL, Hornstein S, et al.: The epidemiology of genital colonization with Staphylococcus aureus. Ann Intern Med 1982, 96(6 Pt 2):940–944.

    PubMed  Google Scholar 

  8. Guinan ME, Dan BB, Guidotti RJ, et al.: Vaginal colonization with Staphylococcus aureus in healthy women: a review of four studies. Ann Intern Med 1982, 96(6 Pt 2):944–947.

    PubMed  CAS  Google Scholar 

  9. Ridley M, Chir B: Perineal carriage of Staphylococcus aureus. BMJ 1959, 270–273.

  10. Pujol M, Pena C, Pallares R, et al.: Nosocomial Staphylococcus aureus bacteremia among nasal carriers of methicillinresistant and methicillin-susceptible strains. Am J Med 1996, 100:509–516.

    Article  PubMed  CAS  Google Scholar 

  11. von Eiff C, Becker K, Machka K, et al.: Nasal carriage as a source of Staphylococcus aureus bacteremia. Study group. N Engl J Med 2001, 344:11–16. Provides direct evidence that the majority of S. aureus infections are caused by carriage isolates found predominantly in the anterior nares.

    Article  Google Scholar 

  12. Yu VL, Goetz A, Wagener M, et al.: Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis. N Engl J Med 1986, 315:91–96.

    Article  PubMed  CAS  Google Scholar 

  13. Corbella X, Dominguez MA, Pujol M, et al.: Staphylococcus aureus nasal carriage as a marker for subsequent staphylococcal infections in intensive care unit patients. Eur J Clin Microbiol Infect Dis 1997, 16:351–357.

    Article  PubMed  CAS  Google Scholar 

  14. Mest DR, Wong DH, Shimoda KJ, et al.: Nasal colonization with methicillin-resistant Staphylococcus aureus on admission to the surgical intensive care unit increases the risk of infection. Anesth Analg 1994, 78:644–650.

    Article  PubMed  CAS  Google Scholar 

  15. Coello R, Glynn JR, Gaspar C, et al.: Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA. J Hosp Infect 1997, 37:39–46.

    Article  PubMed  CAS  Google Scholar 

  16. Boyce JM: Epidemiology and prevention of nosocomial infections. In In The Staphylococci in Human Disease. Edited by Crossley KB, Archer GL. New York: Churchill Livingstone; 1997:309–329.

    Google Scholar 

  17. Harbarth S, Liassine N, Dharan S, et al.: Risk factors for persistent carriage of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 2000, 31:1380–1385. Large trial of mupirocin in the eradication of nasal MRSA colonization that also describes the breadth of MRSA colonization at other body sites.

    Article  PubMed  CAS  Google Scholar 

  18. Troillet N, Carmeli Y, Samore MH, et al.: Carriage of methicillin-resistant Staphylococcus aureus at hospital admission. Infect Control Hosp Epidemiol 1998, 19:181–185.

    PubMed  CAS  Google Scholar 

  19. Asensio A, Guerrero A, Quereda C, et al.: Colonization and infection with methicillin-resistant Staphylococcus aureus: associated factors and eradication. Infect Control Hosp Epidemiol 1996, 17:20–28.

    PubMed  CAS  Google Scholar 

  20. Sanford MD, Widmer AF, Bale MJ, et al.: Efficient detection and long-term persistence of the carriage of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 1994, 19:1123–1128.

    PubMed  CAS  Google Scholar 

  21. Scanvic A, Denic L, Gaillon S, et al.: Duration of colonization by methicillin-resistant Staphylococcus aureus after hospital discharge and risk factors for prolonged carriage. Clin Infect Dis 2001, 32:1393–1398.

    Article  PubMed  CAS  Google Scholar 

  22. Frenay HM, Vandenbroucke-Grauls CM, Molkenboer MJ, Verhoef J: Long-term carriage, and transmission of methicillin-resistant Staphylococcus aureus after discharge from hospital. J Hosp Infect 1992, 22:207–215.

    Article  PubMed  CAS  Google Scholar 

  23. Beaujean DJ, Weersink AJ, Blok HE, et al.: Determining risk factors for methicillin-resistant Staphylococcus aureus carriage after discharge from hospital. J Hosp Infect 1999, 42:213–218.

    Article  PubMed  CAS  Google Scholar 

  24. Hicks NR, Moore EP, Williams EW: Carriage and community treatment of methicillin-resistant Staphylococcus aureus: what happens to colonized patients after discharge? J Hosp Infect 1991, 19:17–24.

    Article  PubMed  CAS  Google Scholar 

  25. Lessing MP, Jordens JZ, Bowler IC: When should healthcare workers be screened for methicillin-resistant Staphylococcus aureus? J Hosp Infect 1996, 34:205–210.

    Article  PubMed  CAS  Google Scholar 

  26. Moreno F, Crisp C, Jorgensen JH, Patterson JE: Methicillinresistant Staphylococcus aureus as a community organism. Clin Infect Dis 1995, 21:1308–1312.

    PubMed  CAS  Google Scholar 

  27. Price MF, Carlini M, Houston S, Gentry LO: Prevalence of nasal colonization with methicillin-resistant Staphylococcus aureus in selected patient populations. Infect Control Hosp Epidemiol 2000, 21:603–605.

    Article  PubMed  CAS  Google Scholar 

  28. Layton MC, Hierholzer WJJr, Patterson JE: The evolving epidemiology of methicillin-resistant Staphylococcus aureus at a university hospital. Infect Control Hosp Epidemiol 1995, 16:12–17.

    Article  PubMed  CAS  Google Scholar 

  29. Papia G, Louie M, Tralla A, et al.: Screening high-risk patients for methicillin-resistant Staphylococcus aureus on admission to the hospital: is it cost effective? Infect Control Hosp Epidemiol 1999, 20:473–477.

    Article  PubMed  CAS  Google Scholar 

  30. Shopsin B, Mathema B, Martinez J, et al.: Prevalence of methicillin-resistant and methicillin-susceptible Staphylococcus aureus in the community. J Infect Dis 2000, 182:359–362.

    Article  PubMed  CAS  Google Scholar 

  31. Abudu L, Blair I, Fraise A, Cheng KK: Methicillin-resistant Staphylococcus aureus (MRSA): a community-based prevalence survey. Epidemiol Infect 2001, 126:351–356.

    Article  PubMed  CAS  Google Scholar 

  32. Hollis RJ, Barr JL, Doebbeling BN, et al.: Familial carriage of methicillin-resistant Staphylococcus aureus and subsequent infection in a premature neonate. Clin Infect Dis 1995, 21:328–332.

    PubMed  CAS  Google Scholar 

  33. Shahin R, Johnson IL, Jamieson F, et al.: Methicillin-resistant Staphylococcus aureus carriage in a child care center following a case of disease. Toronto Child Care Center Study Group. Arch Pediatr Adolesc Med 1999, 153:864–868.

    PubMed  CAS  Google Scholar 

  34. Naimi TS, LeDell KH, Boxrud DJ, et al.: Epidemiology and clonality of community-acquired methicillin-resistant Staphylococcus aureus in Minnesota, 1996–1998. Clin Infect Dis 2001, 33:990–996.

    Article  PubMed  CAS  Google Scholar 

  35. Bukharie HA, Abdelhadi MS, Saeed IA, et al.: Emergence of methicillin-resistant Staphylococcus aureus as a community pathogen. Diagn Microbiol Infect Dis 2001, 40(1-2):1–4.

    Article  PubMed  CAS  Google Scholar 

  36. Hoen B, Paul-Dauphin A, Hestin D, Kessler M: EPIBACDIAL: a multicenter prospective study of risk factors for bacteremia in chronic hemodialysis patients. J Am Soc Nephrol 1998, 9:869–876.

    PubMed  CAS  Google Scholar 

  37. Cox RA, Conquest C: Strategies for the management of healthcare staff colonized with epidemic methicillin-resistant Staphylococcus aureus. J Hosp Infect 1997, 35:117–127.

    Article  PubMed  CAS  Google Scholar 

  38. Meier PA, Carter CD, Wallace SE, et al.: A prolonged outbreak of methicillin-resistant Staphylococcus aureus in the burn unit of a tertiary medical center. Infect Control Hosp Epidemiol 1996, 17:798–802.

    PubMed  CAS  Google Scholar 

  39. Arnow P, Allyn PA, Nichols EM, et al.: Control of methicillinresistant Staphylococcus aureus in a burn unit: role of nurse staffing. J Trauma 1982, 22:954–959.

    Article  PubMed  CAS  Google Scholar 

  40. Cookson B, Peters B, Webster M, et al.: Staff carriage of epidemic methicillin-resistant Staphylococcus aureus. J Clin Microbiol 1989, 27:1471–1476.

    PubMed  CAS  Google Scholar 

  41. Hancox R, Cummins A, Kelsey MC: An outbreak of EMRSA 2 associated with long-term colonization of medical staff. J Hosp Infect 1992, 22:170–172.

    Article  PubMed  CAS  Google Scholar 

  42. Boyce JM: MRSA patients: proven methods to treat colonization and infection. J Hosp Infect 2001, 48(Suppl A):S9-S14.

    Article  PubMed  Google Scholar 

  43. Pittet D, Hugonnet S, Harbarth S, et al.: Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet 2000, 356:1307–1312.

    Article  PubMed  CAS  Google Scholar 

  44. Voss A, Widmer AF: No time for handwashing!? Handwashing versus alcoholic rub: can we afford 100% compliance? Infect Control Hosp Epidemiol 1997, 18:205–208.

    PubMed  CAS  Google Scholar 

  45. Thompson RL, Cabezudo I, Wenzel RP: Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med 1982, 97:309–317.

    PubMed  CAS  Google Scholar 

  46. Thompson BL, Dwyer DM, Ussery XT, et al.: Handwashing and glove use in a long-term-care facility. Infect Control Hosp Epidemiol 1997, 18:97–103.

    Article  PubMed  CAS  Google Scholar 

  47. Lacey S, Flaxman D, Scales J, Wilson A: The usefulness of masks in preventing transient carriage of epidemic methicillin-resistant Staphylococcus aureus by healthcare workers. J Hosp Infect 2001, 48:308–311.

    Article  PubMed  CAS  Google Scholar 

  48. Watanakunakorn C, Axelson C, Bota B, Stahl C: Mupirocin ointment with and without chlorhexidine baths in the eradication of Staphylococcus aureus nasal carriage in nursing home residents. Am J Infect Control 1995, 23:306–309.

    Article  PubMed  CAS  Google Scholar 

  49. Girou E, Pujade G, Legrand P, et al.: Selective screening of carriers for control of methicillin-resistant Staphylococcus aureus (MRSA) in high-risk hospital areas with high level of endemic MRSA. Clin Infect Dis 1998, 27:543–550. Real reductions in MRSA colonization and infection rates were demonstrated with the early detection, contact precautions, and eradication of the carriage state with mupirocin and chlorhexidine body washes.

    PubMed  CAS  Google Scholar 

  50. Balfour A, Higgins J, Brown M, Gallacher G: Eradication of carriage of methicillin-resistant Staphylococcus aureus. J Hosp Infect 1997, 35:320–321.

    Article  PubMed  CAS  Google Scholar 

  51. Parras F, Guerrero D, Bouza E, et al.: Comparative Study of mupirocin and oral co-trimaxazole plus topical fusidic acid in eradication of nasal carriage of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 1995, 39:175–179.

    PubMed  CAS  Google Scholar 

  52. Doebbeling BN, Breneman DL, Neu HC, et al.: Elimination of Staphylococcus aureus nasal carriage in health care workers: analysis of six clinical trials with calcium mupirocin ointment. The Mupirocin Collaborative Study Group. Clin Infect Dis 1993, 17:466–474.

    PubMed  CAS  Google Scholar 

  53. Reagan DR, Doebbeling BN, Pfaller MA, et al.: Elimination of coincident Staphylococcus aureus nasal and hand carriage with intranasal application of mupirocin calcium ointment. Ann Intern Med 1991, 114:101–106.

    PubMed  CAS  Google Scholar 

  54. Soto NE, Vaghjimal A, Stahl-Avicolli A, et al.: Bacitracin versus mupirocin for Staphylococcus aureus nasal colonization. Infect Control Hosp Epidemiol 1999, 20:351–353.

    Article  PubMed  CAS  Google Scholar 

  55. Scully BE, Briones F, Gu JW, Neu HC: Mupirocin treatment of nasal staphylococcal colonization. Arch Intern Med 1992, 152:353–356.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chiang, FY., Climo, M. Staphylococcus aureus carriage and health care-acquired infection. Curr Infect Dis Rep 4, 498–504 (2002). https://doi.org/10.1007/s11908-002-0035-x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11908-002-0035-x

Keywords

Navigation