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Lancet. 2004 Aug 21-27;364(9435):703-5.

Risk and outcome of nosocomial Staphylococcus aureus bacteraemia in nasal carriers versus non-carriers.

Author information

1
Erasmus MC, University Medical Centre, Rotterdam, Department of Medical Microbiology and Infectious Diseases, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands. h.wertheim@erasmusmc.nl

Abstract

Staphylococcus aureus is the second most frequent cause of nosocomial blood infections. We screened 14008 non-bacteraemic, non-surgical patients for S aureus nasal carriage at admission, and monitored them for development of bacteraemia. Nosocomial S aureus bacteraemia was three times more frequent in S aureus carriers (40/3420, 1.2%) than in non-carriers (41/10588, 0.4%; relative risk 3.0, 95% CI 2.0-4.7). However, in bacteraemic patients, all-cause mortality was significantly higher in non-carriers (19/41, 46%) than in carriers (seven/40, 18%, p=0.005). Additionally, S aureus bacteraemia-related death was significantly higher in non-carriers than in carriers (13/41 [32%] vs three/40 [8%], p=0.006). S aureus nasal carriers and non-carriers differ significantly in risk and outcome of nosocomial S aureus bacteraemia. Genotyping revealed that 80% of strains causing bacteraemia in carriers were endogenous.

PMID:
15325835
DOI:
10.1016/S0140-6736(04)16897-9
[Indexed for MEDLINE]

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