title: Staphylococcus aureus carriage among GPs in The Netherlands.
abstract: BACKGROUND
  The extent to which GPs serve as a reservoir for antibiotic-resistant Staphylococcus aureus is unknown and not well studied.
  
  
  OBJECTIVE
  To determine the prevalence of nasal S. aureus carriage among GPs in the Netherlands, as well as the antimicrobial resistance and the genotypes of isolated S. aureus.
  
  
  METHODS
  Observational, point-prevalence, and cross-sectional study.
  
  
  METHODS
  GPs attending the annual conference of the Dutch College of General Practitioners in 2006.
  
  
  METHODS
  Nasal swabs were randomly taken from 395 GPs and analysed for the presence of S. aureus. Antimicrobial susceptibility was determined by a microbroth dilution method and the genotypes by spa typing, which was associated with multilocus sequence typing.
  
  
  RESULTS
  Of the GPs, 129/395 (33%; 95% confidence interval [CI] = 28 to 37%) were carriers of S. aureus. No meticillin-resistant S. aureus (MRSA) was found. Resistance was observed to penicillin (71%; 95% CI = 63 to 79%), fusidic acid (7%; 95% CI = 3 to 13%), and clarithromycin (6%; 95% CI = 3 to 12%). In 72% of the isolates, an MRSA-related genotype of S. aureus was found.
  
  
  CONCLUSIONS
  The low antibiotic resistance found among S. aureus of GPs suggests that GPs are not a reservoir of antibiotic-resistant S. aureus strains. The relatively high resistance to fusidic acid, which has not previously been described in the Netherlands and is mostly because of antibiotic use, suggests that patients infect GPs and not the other way round. GPs may be at risk for nasal carriage of S. aureus with an MRSA-related genotype.
authors.affiliation: Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Michelle Ia
authors.initials: MIa
authors.lastname: Rijnders
authors.forename: Sita
authors.initials: S
authors.lastname: Nys
authors.forename: Christel
authors.initials: C
authors.lastname: Driessen
authors.forename: Christian Jpa
authors.initials: CJ
authors.lastname: Hoebe
authors.forename: Rogier M
authors.initials: RM
authors.lastname: Hopstaken
authors.forename: Guy J
authors.initials: GJ
authors.lastname: Oudhuis
authors.forename: Arno
authors.initials: A
authors.lastname: Timmermans
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Stobberingh
mesh_terms: D002353:Carrier State / Q000453:epidemiology* / Q000635:transmission; D004352:Drug Resistance, Microbial; D004812:Epidemiologic Methods; D005672:Fusidic Acid; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008826:Microbial Sensitivity Tests; D009426:Netherlands / Q000453:epidemiology; D009666:Nose / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D005672:Fusidic Acid