title: Performance of surveillance cultures at different body sites to identify asymptomatic Staphylococcus aureus carriers.
abstract: The objective was to evaluate the performance of surveillance cultures at various body sites for Staphylococcus aureus colonization in pregnant women and newborns (NB) and the factors associated with nasal colonization. For NB, 4 sites were evaluated: nares, oropharynx, perineum, and umbilical stump (birth, third day, and weekly). For pregnant women, 4 sites during labor: anterior nares, anus, perineum, and oropharynx. Nasally colonized patients were compared with colonized only extranasally. Colonization was 53% of 392 pregnant women (methicillin-resistant S. aureus [MRSA]: 4%) and 47% of 382 NB (MRSA: 9%). For newborn patients, the best body site was the umbilical stump (methicillin-susceptible S. aureus [MSSA]: 64%; MRSA: 68%) and the combination of nares + umbilical (MSSA: 86%; MRSA: 91%). Among pregnant women, the best body site was the anterior nares (MSSA: 59%; MRSA: 67%) and the combination of nares + oropharynx (MSSA: 83%; MRSA: 80%). A smaller number of household members were associated with MRSA carriage in pregnant women (2.2 ± 0.6 versus 3.6 ± 1.8; P = 0.04). In conclusion, multiple culture sites are needed. Control programs based on surveillance cultures may be compromised.
authors.affiliation: Department of Infectious Diseases and LIM-54, University of São Paulo, 05403-900 São Paulo, Brazil.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Cursino
authors.forename: Cilmara P
authors.initials: CP
authors.lastname: Garcia
authors.forename: Renata D
authors.initials: RD
authors.lastname: Lobo
authors.forename: Matias C
authors.initials: MC
authors.lastname: Salomão
authors.forename: Satiko
authors.initials: S
authors.lastname: Gobara
authors.forename: Gabriela F
authors.initials: GF
authors.lastname: Raymundo
authors.forename: Thaisa
authors.initials: T
authors.lastname: Kespers
authors.forename: Robson E
authors.initials: RE
authors.lastname: Soares
authors.forename: Carla H
authors.initials: CH
authors.lastname: Mollaco
authors.forename: Kleiste G
authors.initials: KG
authors.lastname: Keil
authors.forename: Paula B
authors.initials: PB
authors.lastname: Malieno
authors.forename: Vera L
authors.initials: VL
authors.lastname: Krebs
authors.forename: Maria Augusta
authors.initials: MA
authors.lastname: Gibelli
authors.forename: Mario M
authors.initials: MM
authors.lastname: Kondo
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
authors.forename: Silvia F
authors.initials: SF
authors.lastname: Costa
authors.forename: Anna S
authors.initials: AS
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D000328:Adult; D001431:Bacteriological Techniques / Q000379:methods*; D002353:Carrier State / Q000175:diagnosis* / Q000382:microbiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000382:microbiology; D009666:Nose / Q000382:microbiology; D010502:Perineum / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000382:microbiology; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D014472:Umbilicus / Q000382:microbiology; D055815:Young Adult