OBJECTIVE: To determine if Staphylococcus aureus colonization of the anterior nares was a risk factor for S aureus infection in patients with cirrhosis and to determine the predictors of S aureus infection in colonized patients. DESIGN: Prospective cohort study. PATIENTS: 84 consecutive patients with cirrhosis admitted to the liver transplant unit of a university-affiliated Veterans' Affairs Medical Center. RESULTS: Overall, 39 (46%) of the 84 patients were nasal carriers of S aureus, of which 24 (29%) were methicillin-resistant Staphylococcus aureus (MRSA) and 15 (18%) were methicillin-sensitive Staphylococcus aureus (MSSA). Only MRSA, but never MSSA, carriage was acquired in the hospital; all 15 of the MSSA versus 14 (58%) of the 24 MRSA carriers were nasal carriers on first (admission) culture (P=.001). Of the 10 (42%) of 24 MRSA carriers who were not colonized on admission, 3 became MRSA carriers within 1 month, and 7 acquired MRSA carriage more than a month later. Higher Child-Pugh score was independently associated with MRSA carriage (odds ratio [OR], 1.54; 95% confidence interval [CI95], 1.1-2.3). S aureus nasal carriers (9 [23%] of 39) were significantly more likely to develop S aureus infections than noncarriers (2 [4%] of 45; P=.02). Central venous catheter use was associated independently with S aureus infections in the carriers (OR, 4.1; CI95 2.8-6.1). Mortality was significantly higher in carriers who developed S aureus infections as compared to those who did not (57% vs 13%; P=.022); S aureus infection was an independent predictor of mortality in the carriers (OR, 8.7; CI95, 1.2-63.8). CONCLUSIONS: Colonization of the anterior nares was a significant predictor of S aureus infection in patients with cirrhosis.
OBJECTIVE: To determine if Staphylococcus aureus colonization of the anterior nares was a risk factor for S aureus infection in patients with cirrhosis and to determine the predictors of S aureus infection in colonized patients. DESIGN: Prospective cohort study. PATIENTS: 84 consecutive patients with cirrhosis admitted to the liver transplant unit of a university-affiliated Veterans' Affairs Medical Center. RESULTS: Overall, 39 (46%) of the 84 patients were nasal carriers of S aureus, of which 24 (29%) were methicillin-resistant Staphylococcus aureus (MRSA) and 15 (18%) were methicillin-sensitive Staphylococcus aureus (MSSA). Only MRSA, but never MSSA, carriage was acquired in the hospital; all 15 of the MSSA versus 14 (58%) of the 24 MRSA carriers were nasal carriers on first (admission) culture (P=.001). Of the 10 (42%) of 24 MRSA carriers who were not colonized on admission, 3 became MRSA carriers within 1 month, and 7 acquired MRSA carriage more than a month later. Higher Child-Pugh score was independently associated with MRSA carriage (odds ratio [OR], 1.54; 95% confidence interval [CI95], 1.1-2.3). S aureus nasal carriers (9 [23%] of 39) were significantly more likely to develop S aureus infections than noncarriers (2 [4%] of 45; P=.02). Central venous catheter use was associated independently with S aureus infections in the carriers (OR, 4.1; CI95 2.8-6.1). Mortality was significantly higher in carriers who developed S aureus infections as compared to those who did not (57% vs 13%; P=.022); S aureus infection was an independent predictor of mortality in the carriers (OR, 8.7; CI95, 1.2-63.8). CONCLUSIONS: Colonization of the anterior nares was a significant predictor of S aureus infection in patients with cirrhosis.
Authors: Enrique Cerdá; Ana Abella; Miguel A de la Cal; José A Lorente; Paloma García-Hierro; Hendrick K F van Saene; Inmaculada Alía; Ainhoa Aranguren Journal: Ann Surg Date: 2007-03 Impact factor: 12.969
Authors: James A McKinnell; Loren G Miller; Samantha J Eells; Eric Cui; Susan S Huang Journal: Infect Control Hosp Epidemiol Date: 2013-08-19 Impact factor: 3.254
Authors: F Bert; M Andreu; F Durand; F Degos; J-O Galdbart; R Moreau; C Branger; N Lambert-Zechovsky; D Valla Journal: Eur J Clin Microbiol Infect Dis Date: 2003-01-29 Impact factor: 3.267
Authors: H J Park; Y-M Lee; K M Bang; S-Y Park; S M Moon; K-H Park; Y P Chong; S-H Kim; S-O Lee; S-H Choi; J-Y Jeong; J H Woo; Y S Kim Journal: Eur J Clin Microbiol Infect Dis Date: 2012-07-26 Impact factor: 3.267
Authors: M Estée Török; Simon R Harris; Edward J P Cartwright; Kathy E Raven; Nicholas M Brown; Michael E D Allison; Daniel Greaves; Michael A Quail; Direk Limmathurotsakul; Matthew T G Holden; Julian Parkhill; Sharon J Peacock Journal: J Antimicrob Chemother Date: 2014-04-30 Impact factor: 5.790
Authors: Anthony D Harris; Jessina C McGregor; Judith A Johnson; Sandra M Strauss; Anita C Moore; Harold C Standiford; Joan N Hebden; J Glenn Morris Journal: Emerg Infect Dis Date: 2007-08 Impact factor: 6.883