Journal Article

Risk Factors for Persistent Carriage of Methicillin-Resistant <i>Staphylococcus aureus</i>

Stephan Harbarth, Nadia Liassine, Sasi Dharan, Pascale Herrault, Raymond Auckenthaler and Didier Pittet

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 6, pages 1380-1385
Published in print December 2000 | ISSN: 1058-4838
Published online December 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/317484
Risk Factors for Persistent Carriage of Methicillin-Resistant Staphylococcus aureus

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We determined risk factors associated with persistent carriage of methicillin-resistant Staphylococcus aureus (MRSA) among 102 patients enrolled in a double-blind, placebo-controlled trial of nasally administered mupirocin ointment. MRSA decolonization was unsuccessful in 77 (79%) of 98 patients who met the criteria for evaluation. By univariate analysis, 4 variables were found to be associated with persistent MRSA colonization (P < .1 for all 4): absence of mupirocin treatment, previous fluoroquinolone therapy, ⩾2 MRSA-positive body sites, and low-level mupirocin resistance. After multivariable Cox proportional hazards modeling, the presence of ⩾2 positive body sites (adjusted hazard ratio [AHR], 1.7; 95% confidence interval [CI], 1.0–2.9) and previous receipt of a fluoroquinolone (AHR, 1.8; 95% CI, 1.0–3.3) were independently associated with MRSA persistence, whereas nasal mupirocin tended to confer protection (AHR, 0.6; 95% CI, 0.4–1.0). Low-level mupirocin resistance was observed in 9 genotypically different MRSA strains and was not independently associated with chronic MRSA carriage (AHR, 1.5; 95% CI, 0.9–2.5). Our findings suggest that multisite MRSA carriage and previous receipt of a fluoroquinolone are independent risk factors for persistent MRSA colonization.

Journal Article.  4204 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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