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Rates of Carriage of Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus in an Outpatient Population

Published online by Cambridge University Press:  02 January 2015

Julie Kenner ,
Tasha O'Connor ,
Nicholas Piantanida ,
Joel Fishbain ,
Bardwell Eberly ,
Helen Viscount ,
Catherine Uyehara  and
Duane Hospenthal
Julie Kenner*
Affiliation:
Tripler Army Medical Center, Tripler
Tasha O'Connor
Affiliation:
Tripler Army Medical Center, Tripler
Nicholas Piantanida
Affiliation:
U.S. Army Health Clinic at Schofield Barracks, Schofield, Hawaii
Joel Fishbain
Affiliation:
Tripler Army Medical Center, Tripler
Bardwell Eberly
Affiliation:
Tripler Army Medical Center, Tripler
Helen Viscount
Affiliation:
Tripler Army Medical Center, Tripler
Catherine Uyehara
Affiliation:
Tripler Army Medical Center, Tripler
Duane Hospenthal
Affiliation:
Tripler Army Medical Center, Tripler
*
1006 Koohoo Place, Kailua, HI 96734
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Abstract

Objectives:

To assess the prevalence of and the clinical features associated with asymptomatic Staphylococcus aureus colonization in a healthy outpatient population, and to compare the characteristics of colonizing methicillin-resistant S. aureus (MRSA) strains with those of strains causing infection in our community and hospital.

Setting:

Outpatient military clinics.

Methods:

Specimens were obtained from the nares, pharynx, and axillae of 404 outpatients, and a questionnaire was administered to obtain demographic and risk factor information. MRSA strains were typed by pulsed-field gel electrophoresis (PFGE) and evaluated for antibiotic susceptibility. Antibiograms of study MRSA strains were compared with those of MRSA strains causing clinical illness during the same time period.

Results:

Methicillin-susceptible S. aureus (MSSA) colonization was present in 153 (38%) of the 404 asymptomatic outpatients, and MRSA colonization was present in 8 (2%). Detection of colonization was highest from the nares. No clinical risk factor was significantly associated with MRSA colonization; however, a tendency was noted for MRSA to be more common in men and in those who were older or who had been recently hospitalized. All colonizing MRSA strains had unique patterns on PFGE. In contrast to strains responsible for hospital infections, most colonizing isolates of MRSA were susceptible to oral antibiotics.

Conclusions:

MRSA and MSSA colonization is common in our outpatient population. Colonization is best detected by nares cultures and most carriers of MRSA are without apparent predisposing risk factors for acquisition. Colonizing isolates of MRSA are heterogeneous and, unlike nosocomial isolates, often retain susceptibility to other non-beta-lactam antibiotics.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 6 , June 2003 , pp. 439 - 444
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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