title: Basic rules of hygiene protect health care and lab workers from nasal colonization by Staphylococcus aureus: an international cross-sectional study.
abstract: Acquisition of nasal Staphylococcus aureus (S. aureus) colonization by contaminated hands is likely an important determinant of its nasal carriage rate in health care and lab setting. The objective of our cross-sectional study was to assess the prevalence of nasal methicillin-sensitive (MSSA) or -resistant Staphylococcus aureus (MRSA) carriage among health care professionals (HCPs) attending an international symposium and to study the association between compliance with hygiene rules, individual-related parameters, and medical conditions with nasal S. aureus carriage in this population. After obtaining consent, two nasal swabs were collected. Nasal MSSA and MRSA carriage was measured by the: i) molecular approach targeting spa, mecA and mecA-orfX junction sequences, and ii) culture on selective S. aureus media combined with mecA molecular detection of isolated strains. Information on compliance with hygiene rules, demographic variables, sector of activity and long-term medication was collected by anonymous questionnaire. The participation rate was 32.3%. In total, 176 subjects from 34 countries were included in the analysis. S. aureus was isolated from the nasal swabs of 57 (32.4%) subjects, of whom 3 (5.3%) harbored MRSA strains. Overall, 123 subjects reported working in microbiology laboratories with direct manipulation of S. aureus, and 29 acknowledged regular contacts with patients. In this exposed population, hydro-alcoholic solutions appeared to have a significant protective effect against nasal S. aureus carriage (OR = 0.36; 95% CI: 0.15-0.85). Hospital work was associated with increased risk of nasal S. aureus carriage (OR = 2.38; 95% CI: 1.07-5.29). The results of this study showed that compliance with basic rules of hygiene, such as the use of hydro-alcoholic solutions, could reduce the risk of nasal S. aureus colonization. Hydro-alcoholic solution could interrupt auto-transmission of the pathogen, consequently decreasing the overall nasal carriage rate, specifically in transient carriers.
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France.
authors.forename: Mitra
authors.initials: M
authors.lastname: Saadatian-Elahi
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France ; Université de Lyon, Institut National de la Santé et de la Recherche Médicale U1111, Lyon, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Tristan
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France ; Université de Lyon, Institut National de la Santé et de la Recherche Médicale U1111, Lyon, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Laurent
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France ; Université de Lyon, Institut National de la Santé et de la Recherche Médicale U1111, Lyon, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Rasigade
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France ; Université de Lyon, Institut National de la Santé et de la Recherche Médicale U1111, Lyon, France.
authors.forename: Coralie
authors.initials: C
authors.lastname: Bouchiat
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France.
authors.forename: Anne-Gaëlle
authors.initials: AG
authors.lastname: Ranc
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France ; Université de Lyon, Institut National de la Santé et de la Recherche Médicale U1111, Lyon, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Lina
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Dauwalder
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France ; Université de Lyon, Institut National de la Santé et de la Recherche Médicale U1111, Lyon, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Etienne
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France ; Université de Lyon, Institut National de la Santé et de la Recherche Médicale U1111, Lyon, France.
authors.forename: Michèle
authors.initials: M
authors.lastname: Bes
authors.affiliation: Centre National de Références des Staphylocoques, Hospices Civils de Lyon, Lyon, France ; Université de Lyon, Institut National de la Santé et de la Recherche Médicale U1111, Lyon, France.
authors.forename: François
authors.initials: F
authors.lastname: Vandenesch
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D006920:Hygiene; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000472:pathogenicity; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology; D009666:Nose / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000472:pathogenicity