Author:
Bischoff Werner E.,Wallis Michelle L.,Tucker Keith B.,Reboussin Beth A.,Sherertz Robert J.
Abstract
AbstractObjective:To evaluate the prevalence and risk factors of nasalStaphylococcus 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.
Publisher
Cambridge University Press (CUP)
Subject
Infectious Diseases,Microbiology (medical),Epidemiology
Cited by
77 articles.
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