title: Nasal Staphylococcus aureus carriage is not a risk factor for lower-airway infection in young cystic fibrosis patients.
abstract: Staphylococcus aureus is one of the first pathogens which often persistently infect the airways of cystic fibrosis (CF) patients. Nasal S. aureus carriage is a risk factor for S. aureus infections in non-CF patients. Topical treatment strategies successfully eradicate nasal S. aureus carriage, thereby decreasing S. aureus infection. A prospective longitudinal multicenter study was conducted to assess whether nasal carriage represents a risk factor for S. aureus colonization of the oropharynx in young CF patients. Cross-sectional analysis revealed a significantly higher prevalence of S. aureus-positive nasal (28/80 [35%] versus 20/109 [18%]; P < 0.01) and oropharyngeal (35/80 [44%] versus 20/109 [18%]; P < 0.001) cultures in children with CF compared to a control group. The first site of S. aureus detection was the nose in 6 patients and the oropharynx in 14 patients, respectively. Longitudinal analysis demonstrated a significantly higher S. aureus prevalence (61/62 [98%] versus 47/62 [76%]; P < 0.001) and persistence (46/62 [74%] versus 31/62 [50%]; P < 0.01) in the oropharynx than in the nose. In CF patients, the oropharynx, and not the nose, was the predominant site of S. aureus infection and persistence. Hence, it is unlikely that CF patients will benefit from topical treatment strategies to eradicate nasal carriage.
authors.affiliation: Institute of Medical Microbiology, University of Muenster Hospital, Domagkstr. 10, 48149 Muenster, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Ridder-Schaphorn
authors.forename: Felix
authors.initials: F
authors.lastname: Ratjen
authors.forename: Angelika
authors.initials: A
authors.lastname: Dübbers
authors.forename: Johannes
authors.initials: J
authors.lastname: Häberle
authors.forename: Sabine
authors.initials: S
authors.lastname: Falk
authors.forename: Peter
authors.initials: P
authors.lastname: Küster
authors.forename: Antje
authors.initials: A
authors.lastname: Schuster
authors.forename: Uwe
authors.initials: U
authors.lastname: Mellies
authors.forename: Brigitte
authors.initials: B
authors.lastname: Löwe
authors.forename: Ralf
authors.initials: R
authors.lastname: Reintjes
authors.forename: Georg
authors.initials: G
authors.lastname: Peters
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Kahl
mesh_terms: D000942:Antigens, Bacterial; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009666:Nose / Q000382:microbiology*; D009960:Oropharynx / Q000382:microbiology; D015995:Prevalence; D011446:Prospective Studies; D011956:Receptors, Cell Surface; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*
chemical_list: D000942:Antigens, Bacterial; C512792:IsdH protein, Staphylococcus aureus; D011956:Receptors, Cell Surface