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Wheeless' Textbook of Orthopaedics

Staph aureus: Nasal Carriage



- See:
      - S. epidermidis
      - S. aureus

- Discussion:
        - about 20 % of people almost always carry a strain of staph aureus, and approximately 60 % harbor S. aureus on an intermittent basis;
        - in the study by C. von Eiff et al, isolates from blood and from nasal specimens to determine whether the
              organisms in the bloodstream originated from the patient's own flora;
              - swabs for culture were obtained from the anterior nares of 219 patients with S. aureus bacteremia;
              - total of 723 isolates were collected and genotyped;
              - in a second study, 1640 S. aureus isolates from nasal swabs from 1278 patients were collected over
                      a period of five years and then compared with isolates from the blood of patients who
                      subsequently had S. aureus bacteremia;
              - blood isolates were identical to those from the anterior nares in 180 of 219 patients (82.2 %)'
              - 14 of 1278 patients who had nasal colonization with S. aureus subsequently had S. aureus bacteremia'
                      - in 12 of these 14 patients (86 percent), the isolates obtained from the nares were clonally identical to
                              the isolates obtained from blood 1 day to 14 months later;
              - the authors noted substantial proportion of cases of S. aureus bacteremia appear to be of endogenous origin since
                      they originate from colonies in the nasal mucosa.








Impetigo contagiosa III. Comparative efficacy of oral erythromycin and topical mupirocin.

Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis.

The efficacy of calcium mupirocin in the eradication of nasal Staphylococcus aureus carriage.

Eradication of colonization by methicillin-resistant Staphylococcus aureus by using oral minocycline-rifampin and topical mupirocin.

Alteration of staphylococcal flora in cardiac surgery patients receiving     ³ antibiotic prophylaxis.

Nasal Carriage as a Source of Staphylococcus aureus Bacteremia.   Christof von Eiff. N Engl J Med 2001;344:11-6;







Original Text by Clifford R. Wheeless, III, MD.