Preoperative risk factors for nasal carriage of Staphylococcus aureus

Loreen A Herwaldt; Joseph J Cullen; Pamela French; Jianfang Hu; Michael A Pfaller; Richard P Wenzel; Trish M Perl

doi:10.1086/502426

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Preoperative risk factors for nasal carriage of Staphylococcus aureus

Journal article

Peer reviewed

Preoperative risk factors for nasal carriage of Staphylococcus aureus

Loreen A Herwaldt, Joseph J Cullen, Pamela French, Jianfang Hu, Michael A Pfaller, Richard P Wenzel and Trish M Perl

Infection control and hospital epidemiology, Vol.25(6), pp.481-484

06/2004

DOI: 10.1086/502426

PMID: 15242196

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Abstract

Staphylococcus aureus nasal carriage is a risk factor for surgical-site infections (SSIs) caused by S. aureus, and eradication of carriage reduces postoperative nosocomial infections caused by it. No study has compared large groups of preoperative carriers and non-carriers to identify factors that are linked to S. aureus nasal carriage. While conducting a clinical trial evaluating whether mupirocin prevented S. aureus SSIs, we prospectively collected data on 70 patient characteristics that might be associated with S. aureus carriage. We performed stepwise logistic regression analysis. Of the 4,030 patients, 891 (22%) carried S. aureus. Independent risk factors for S. aureus nasal carriage were obesity (odds ratio [OR], 1.29; 95% confidence interval [CI95], 1.11-1.50), male gender (OR, 1.29; CI95, 1.11-1.51), and a history of a cerebrovascular accident (OR, 1.53; CI95, 1.03-2.25) for all patients. Factors associated with nasal carriage varied somewhat by surgical specialty. In all groups, preoperative use of antimicrobial agents was independently associated with a lower risk of carrying S. aureus in the nares. Previously identified risk factors were not significantly associated with S. aureus nasal carriage in this large group of surgical patients. Male gender, obesity, and a history of a cerebrovascular accident were identified as risk factors for S. aureus nasal carriage. It remains to be seen whether preoperative weight loss would reduce the rate of nasal carriage. In addition, the value of screening this patient population for S. aureus nasal carriage merits further investigation.

Carrier State - epidemiology

Prospective Studies

Age Factors

Humans

Middle Aged

Carrier State - microbiology

Mupirocin - administration & dosage

Male

Adult

Female

Iowa - epidemiology

Cross Infection - epidemiology

Surgical Wound Infection - epidemiology

Hospitals, University - statistics & numerical data

Risk Assessment

Staphylococcus aureus - isolation & purification

Cross Infection - prevention & control

Hospitals, Veterans - statistics & numerical data

Risk Factors

Logistic Models

Surgical Wound Infection - prevention & control

Nasal Mucosa - microbiology

Staphylococcal Infections - epidemiology

Cross Infection - microbiology

Staphylococcal Infections - prevention & control

Aged

Surgical Wound Infection - microbiology

Staphylococcus aureus - drug effects

Anti-Bacterial Agents - administration & dosage

Details

Title: Subtitle: Preoperative risk factors for nasal carriage of Staphylococcus aureus
Creators: Loreen A Herwaldt - Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa 52242-1081, USA
Joseph J Cullen
Pamela French
Jianfang Hu
Michael A Pfaller
Richard P Wenzel
Trish M Perl
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology, Vol.25(6), pp.481-484
Publisher: United States
DOI: 10.1086/502426
PMID: 15242196
ISSN: 0899-823X
eISSN: 1559-6834
Language: English
Date published: 06/2004
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Surgery; Radiation Oncology; Internal Medicine
Record Identifier: 9984051742302771

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