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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.

Original publication

DOI

10.1016/S0140-6736(04)16897-9

Type

Journal article

Journal

Lancet

Publication Date

21/08/2004

Volume

364

Pages

703 - 705

Keywords

Bacteremia, Bacterial Typing Techniques, Carrier State, Cross Infection, Female, Hospital Mortality, Humans, Length of Stay, Male, Middle Aged, Nasal Cavity, Risk Factors, Staphylococcal Infections, Staphylococcus aureus