Nasal Carriage as a Source of Staphylococcus aureus Bacteremia
Open accessAbstract
BACKGROUND: The consequences of infection with Staphylococcus aureus can be severe, so strategies for prevention are important. We examined S. aureus isolates from blood and from nasal specimens to determine whether the organisms in the bloodstream originated from the patient's own flora. METHODS: In a multicenter study, swabs for culture were obtained from the anterior nares of 219 patients with S. aureus bacteremia. A total of 723 isolates were collected and genotyped. In a second study, 1640 S. aureus isolates from nasal swabs were collected over a period of five years and then compared with isolates from the blood of patients who subsequently had S. aureus bacteremia. RESULTS: In the multicenter study of S. aureus bacteremia, the blood isolates were identical to those from the anterior nares in 180 of 219 patients (82.2 percent). In the second study, 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. CONCLUSIONS: A substantial proportion of cases of S. aureus bacteremia appear to be of endogenous origin since they originate from colonies in the nasal mucosa. These results provide support for strategies to prevent systemic S. aureus infections by eliminating nasal carriage of S. aureus.
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S. aureus nasal carriage is a risk factor for subsequent development of community-acquired and nosocomial staphylococcal infections.
“S. aureus nasal carriage, present in about 20% of the general population, has been identified as a risk factor for the subsequent development of community-acquired and nosocomial staphylococcal infections (14, 22).”
From Methicillin-Resistant <i>Staphylococcus aureus</i> Nasal Carriage among Injection Drug Users: Six Years Later (2008) · cites this paper as [22]
The Discussion (page not provided) associates nasal carriage with increased infection risk in surgical and dialysis patients and identifies it as a risk factor for nosocomial bacteremia during an ICU outbreak. The paper also reports that nasal strains preceded bloodstream infections, but it does not establish carriage as a risk factor specifically for community-acquired infections. (LLM, conf=0.84)
Experimental — accuracy not yet measuredS. aureus nasal carriage is present in about 20% of the general population.
“S. aureus nasal carriage, present in about 20% of the general population, has been identified as a risk factor for the subsequent development of community-acquired and nosocomial staphylococcal infections (14, 22).”
From Methicillin-Resistant <i>Staphylococcus aureus</i> Nasal Carriage among Injection Drug Users: Six Years Later (2008) · cites this paper as [22]
Iron acquisition is necessary for Staphylococcus aureus colonization and for the pathogenesis that follows.
“Iron acquisition is required for S. aureus colonization and subsequent pathogenesis.”
From Molecular Mechanisms of <i>Staphylococcus aureus</i> Iron Acquisition (2011) · cites this paper as [82]
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Self-citation
- Authors
- von Eiff, C., Becker, K., Machka, K., Stammer, H., & Peters, G.
- Affiliations
- University of Münster (DE)
- ORCID
- Becker, Karsten
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2001-01-04
- Volume
- 344
- Issue
- 1
- Pages
- 11-16
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2330028620
- Cited by
- 1,984
- References
- 40
- Citations by year
- 2026: 44 · 2025: 49 · 2024: 74 · 2023: 68 · 2022: 69 · 2021: 62 · 2020: 87 · 2019: 84 · 2018: 81 · 2017: 74 · 2016: 91 · 2015: 116 · 2014: 113 · 2013: 107 · 2012: 89
- FWCI
- 46.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Westfälische Wilhelms-Universität Münster
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
- Keywords
- Staphylococcus aureus, bacteremia, nasal carriage, endogenous infection, anterior nares, clonal identity, bloodstream infection, infection control, genotyping
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Carrier State, Child, Child, Preschool, Cross Infection, Female, Germany, Hospitals, Community, Hospitals, General, Humans, Infant, Male, Middle Aged, Nose, Staphylococcal Infections, Staphylococcus aureus, Bacterial Typing Techniques, Methicillin Resistance, Bacteremia, Electrophoresis, Gel, Pulsed-Field
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