Hair follicles as a niche of Staphylococcus aureus in the nose; is a more effective decolonisation strategy needed?

Summary Staphylococcus aureus is the major cause of surgical site infections, and meticillin-resistant S. aureus (MRSA) is increasingly accounting for infections worldwide. Preventing surgical site infections by screening and decolonising positive patients reduces the number of infections, but does...

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Bibliographic Details
Published in:The Journal of hospital infection 2010-11, Vol.76 (3), p.211-214
Main Authors: ten Broeke-Smits, N.J.P, Kummer, J.A, Bleys, R.L.A.W, Fluit, A.C, Boel, C.H.E
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacterial diseases
Biological and medical sciences
Carrier State - drug therapy
Carrier State - microbiology
Epithelium - microbiology
Female
Hair Follicle - microbiology
Human bacterial diseases
Humans
Immunohistochemistry
Infectious Disease
Infectious diseases
Male
Medical sciences
Middle Aged
Mupirocin
Nasal colonisation
Nose - cytology
Nose - microbiology
Pharmacology. Drug treatments
Staphylococcal Infections - drug therapy
Staphylococcal Infections - microbiology
Staphylococcal infections, streptococcal infections, pneumococcal infections
Staphylococcus aureus
Staphylococcus aureus - isolation & purification
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Summary:Summary Staphylococcus aureus is the major cause of surgical site infections, and meticillin-resistant S. aureus (MRSA) is increasingly accounting for infections worldwide. Preventing surgical site infections by screening and decolonising positive patients reduces the number of infections, but does not completely eradicate the risk. A balance between prevention, costs and the chance of mupirocin-resistant S. aureus needs to be evaluated and decolonisation strategies optimised. It is essential to know the site of S. aureus during colonisation. In this study, for the first time the exact location of S. aureus in the human nose was determined using a histological approach. We showed the presence of S. aureus in the cornified layer of squamous epithelium, associated keratin and mucous debris and within hair follicles in the vestibulum nasi. The presence of S. aureus in hair follicles suggests that this could be the niche from which relapses occur after decolonisation. Decolonisation strategies might have to be reconsidered.
ISSN:0195-6701
1532-2939
DOI:10.1016/j.jhin.2010.07.011