title: Antibiotic surgical prophylaxis increases nasal carriage of antibiotic-resistant staphylococci.
abstract: Staphylococci are a significant cause of hospital-acquired infection. Nasal carriage of Staphylococcus aureus is an important risk factor for infection in surgical patients and coagulase-negative staphylococci (CNS) are a major cause of prosthetic joint infections. The impact that antibiotic surgical prophylaxis has on the nasal carriage of staphylococci has not been studied. Daily nasal swabs were taken from 63 patients who received antibiotic surgical prophylaxis and 16 patients who received no antibiotics. Total aerobic bacterial count, S. aureus and CNS were enumerated by culture from nasal swabs. Representative isolates were typed by staphylococcal interspersed repeat units (SIRU) typing and PFGE, and MICs to nine antibiotics were determined. After antibiotic administration, there was a reduction in S. aureus counts (median - 2.3 log(10)c.f.u. ml(- 1)) in 64.0 % of S. aureus carriers, compared with only a 0.89 log(10)c.f.u. ml(- 1) reduction in 75.0 % of S. aureus carriers who did not receive antibiotics. A greater increase in the nasal carriage rate of meticillin-resistant CNS was observed after antibiotic surgical prophylaxis compared with hospitalization alone, with increases of 16.4 and 4.6 %, respectively. Antibiotic-resistant S. epidermidis carriage rate increased by 16.6 % after antibiotic administration compared with 7.5 % with hospitalization alone. Antibiotic surgical prophylaxis impacts the nasal carriage of both S. aureus and CNS.
authors.affiliation: Heart of England NHS Foundation Trust, Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK.|Institute of Microbiology and Infection, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.
authors.forename: Claire L
authors.initials: CL
authors.lastname: McMurray
authors.affiliation: Institute of Microbiology and Infection, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.|Public Health England Birmingham Laboratory, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Hardy
authors.affiliation: Statistics Unit, Statistics, Modelling and Economics Department, Public Health England, Colindale, London NW9 5EQ, UK.
authors.forename: Neville Q
authors.initials: NQ
authors.lastname: Verlander
authors.affiliation: Institute of Microbiology and Infection, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.|Public Health England Birmingham Laboratory, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Hawkey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002353:Carrier State; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000382:microbiology*; D059035:Perioperative Period; D013210:Staphylococcus / Q000145:classification / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents