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Staphylococcus aureus Nasal Carriage in a Student Community Prevalence, Clonal Relationships, and Risk Factors

Published online by Cambridge University Press:  02 January 2015

Werner E. Bischoff*
Affiliation:
Department of Internal Medicine, Section on Infectious Diseases, Winston-Salem, North Carolina
Michelle L. Wallis
Affiliation:
Department of Internal Medicine, Section on Infectious Diseases, Winston-Salem, North Carolina
Keith B. Tucker
Affiliation:
Department of Internal Medicine, Section on Infectious Diseases, Winston-Salem, North Carolina
Beth A. Reboussin
Affiliation:
Section on Biostatistics, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Robert J. Sherertz
Affiliation:
Department of Internal Medicine, Section on Infectious Diseases, Winston-Salem, North Carolina
*
Wake Forest University School of Medicine, Department of Internal Medicine, Section on Infectious Diseases, Medical Center Boulevard, Winston-Salem, NC 27157-1042

Abstract

Objective:

To evaluate the prevalence and risk factors of nasal Staphylococcus aureus (SA) in the community.

Design:

Cross-sectional study.

Setting:

Wake Forest University, Winston-Salem, North Carolina.

Participants:

Four hundred fifty students were screened for nasal SA carriage during the fall of 2000, 2001, and 2002.

Methods:

Students were screened by nose swabs. A self-administered questionnaire collected information on demographics and medical history. Antibiotic testing and PFGE were performed on isolates. Risk factors were determined by logistic regression analysis.

Results:

Of 450 volunteers, 131 (29%) were SA carriers. Antibiotic resistance was high for azithromycin (26%) and low for ciprofloxacin (1%), tetracycline (5%), mupirocin (1%), and methicillin (2%). PFGE patterns were not associated with carriage. Age, male gender, white race, medical student, allergen injection therapy, chronic sinusitis, rheumatoid arthritis, hospitalization for 6 months or less, and use of antibiotics were associated with carrier status by univariate analysis. Stepwise multivariate logistic regression led to a best fitting model with older age (OR, 1.04; CI95, 1.005-1.079), male gender (OR, 1.50; CI95, 0.982-2.296), and chronic sinusitis (OR, 2.71; CI95, 0.897-8.195) as risk factors. Antibiotic use (< 4 weeks) (OR, 0.41; CI95, 0.152-1.095) and allergen injection therapy (OR 0.41; CI95, 0.133-1.238) were protective. Analyses of carriers revealed candidate factors for persistent carriage to be nasal SA colonization rate and male gender. Factors for azithromycin resistance were non-medical students and antibiotic use in the past 6 months.

Conclusion:

Older male volunteers suffering from chronic sinusitis and not taking antibiotics were at higher risk for carrying SA.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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