The role of nasal carriage in Staphylococcus aureus infections
Abstract
Staphylococcus aureus is a frequent cause of infections in both the community and hospital. Worldwide, the increasing resistance of this pathogen to various antibiotics complicates treatment of S aureus infections. Effective measures to prevent S aureus infections are therefore urgently needed. It has been shown that nasal carriers of S aureus have an increased risk of acquiring an infection with this pathogen. The nose is the main ecological niche where S aureus resides in human beings, but the determinants of the carrier state are incompletely understood. Eradication of S aureus from nasal carriers prevents infection in specific patient categories-eg, haemodialysis and general surgery patients. However, recent randomised clinical trials in orthopaedic and non-surgical patients failed to show the efficacy of eliminating S aureus from the nose to prevent subsequent infection. Thus we must elucidate the mechanisms behind S aureus nasal carriage and infection to be able to develop new preventive strategies. We present an overview of the current knowledge of the determinants (both human and bacterial) and risks of S aureus nasal carriage. Studies on the population dynamics of S aureus are also summarised.
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Bacterial colonization of the URT is generally considered as the first step in the development of invasive bacterial infections, including secondary bacterial infections following respiratory viral infection.
“bacterial colonization of the URT is generally considered as the first step in the development of invasive bacterial infections (83, 84), including secondary bacterial infections following respiratory viral infection”
From Respiratory viral infection-induced microbiome alterations and secondary bacterial pneumonia. (2018) · cites this paper as [83]
S. aureus is transiently carried in the nose of 30% of the population, and 20% have persistent nasal colonization.
“S. aureus is transiently carried in the nose of 30% of the population, whilst 20% of the population have persistent nasal colonization (Wertheim et al., 2005).”
From Secondary bacterial infections associated with influenza pandemics (2017) · cites this paper as Wertheim et al., 2005
S. aureus is an opportunistic pathogen and a major cause of bacteraemia.
“Like H. influenzae and S. pneumoniae, S. aureus is an opportunistic pathogen and a major cause of bacteraemia (Wertheim et al., 2005; Tong et al., 2015).”
From Secondary bacterial infections associated with influenza pandemics (2017) · cites this paper as Wertheim et al., 2005
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- Authors
- Wertheim, H. F., Melles, D. C., Vos, M. C., van Leeuwen, W., van Belkum, A., Verbrugh, H. A., & Nouwen, J. L.
- Affiliations
- Erasmus MC (NL)
- Corresponding author
- Wertheim, Heiman FL
- Venue
- The Lancet Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2005-12
- Volume
- 5
- Issue
- 12
- Pages
- 751-762
- ISSN
- 1473-3099 (ISSN-L)
- OpenAlex
- W2098533519
- Cited by
- 2,685
- References
- 198
- Citations by year
- 2026: 96 · 2025: 138 · 2024: 175 · 2023: 130 · 2022: 146 · 2021: 181 · 2020: 191 · 2019: 161 · 2018: 173 · 2017: 162 · 2016: 145 · 2015: 155 · 2014: 162 · 2013: 155 · 2012: 127
- FWCI
- 4.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Funders
- Nierstichting
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
- Keywords
- Staphylococcus aureus, nasal carriage, infection control, antibiotic resistance, hemodialysis patients, orthopedic surgery, population dynamics, community-acquired infections, nosocomial infections
- MeSH terms
- Adolescent, Adult, Aged, Carrier State, Child, Child, Preschool, Female, Humans, Infant, Male, Middle Aged, Nose, Risk Factors, Staphylococcal Infections, Staphylococcus aureus
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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