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Nasal Carriage of Staphylococcus aureus Among Patients Receiving Allergen-Injection Immunotherapy: Associated Factors and Quantitative Nasal Cultures

Published online by Cambridge University Press:  02 January 2015

Stefano Bassetti
Affiliation:
Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North-Carolina
Donnie P. Dunagan
Affiliation:
Section on Pulmonary/Critical Care Medicine, Wake Forest University School of Medicine, Winston-Salem, North-Carolina
Ralph B. D'Agostino Jr
Affiliation:
Section on Biostatistics, Wake Forest University School of Medicine, Winston-Salem, North-Carolina
Robert J. Sherertz*
Affiliation:
Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North-Carolina
*
Section on Infectious Diseases, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1042

Abstract

Objective:

To compare the prevalence of nasal Staphylococcus aureus carriage among outpatients receiving allergen-injection immunotherapy with the prevalence among healthy controls and to determine predictors of nasal S aureus carriage.

Design:

Survey.

Setting:

Allergy clinic of a university hospital.

Participants:

A volunteer sample consisting of 45 outpatients undergoing desensitization therapy and 84 first- and second-year medical students.

Results:

The nasal S aureus carriage rate was significantly higher among patients (46.7%) than among students (26.2%; P=.019). In a multivariate model adjusted for age and gender, the presence of atopic dermatitis or eczema was the only independent predictor of nasal S aureus carriage (odds ratio [OR], 4.4; 95% confidence interval [CI95], 1.2-16.0; P=.02). The only other participant characteristic associated with nasal S aureus carriage was immunotherapy with allergen injections (OR, 1.98; CI95, 0.7-6.0), but this association did not reach statistical significance (P=.23). The probability of nasal S aureus carriage was 88.9% for patients receiving allergen injections and having atopic dermatitis or eczema, and 36.1% for patients receiving allergen injections without atopic dermatitis or eczema.

Conclusions:

Patients undergoing desensitization have a higher nasal carriage rate of S aureus. However, factors other than the regular use of needles, and in particular abnormalities related to the atopic constitution of these patients, may predispose this population for S aureus carriage.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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