title: Molecular and epidemiologic predictors of Staphylococcus aureus colonization site in a population with limited nosocomial exposure.
abstract: BACKGROUND
  The anterior naris has been considered the most consistent location of asymptomatic Staphylococcus aureus colonization. However, recent studies have shown that a substantial number of individuals, ranging from 7% to 32% of colonized individuals, are exclusive throat carriers. Most of these studies have been carried out in a health care setting, limiting their generalizability to nonhospitalized populations.
  
  
  METHODS
  To evaluate anatomic carriage sites of S aureus in individuals outside of a health care setting, we combined the results of 2 cross-sectional studies conducted in Iowa.
  
  
  RESULTS
  S aureus was carried by 103 of 340 individuals (30.3%), including 31 (30.1%) exclusive throat carriers, 44 (42.7%) exclusive nose carriers, and 28 (27.2%) colonized in both sites. Nonwhite race (adjusted odds ratio [OR], 4.91; 95% confidence interval [CI], 1.26-18.3) and younger age (≥30 years: OR, 0.23; 95% CI, 0.10-0.54) were associated with increased odds of exclusive throat carriage, whereas nonwhite race (OR, 5.14; 95% CI, 1.62-16.3) and spring or summer sampling season (OR, 2.62; 95% CI, 1.32-5.18) were associated with increased odds of exclusive nasal carriage.
  
  
  CONCLUSIONS
  These findings suggest that including a throat swab in addition to a nasal swab could play an important role in the success of surveillance programs, particularly among younger adults.
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA. tara-smith@uiowa.edu
authors.forename: Tara C
authors.initials: TC
authors.lastname: Smith
authors.forename: Brett M
authors.initials: BM
authors.lastname: Forshey
authors.forename: Blake M
authors.initials: BM
authors.lastname: Hanson
authors.forename: Shylo E
authors.initials: SE
authors.lastname: Wardyn
authors.forename: Erin D
authors.initials: ED
authors.lastname: Moritz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000382:microbiology*; D010614:Pharynx / Q000382:microbiology*; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D055815:Young Adult