Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 8 , Pages 979-983, August 2007

Staphylococcus aureus Colonization in Community-Dwelling People With Spinal Cord Dysfunction

  • Mary-Claire Roghmann, MD, MS

      Affiliations

    • VA Maryland Health Care System, Baltimore, MD
    • Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
    • Corresponding Author InformationCorrespondence to Mary-Claire Roghmann, MD, MS, 100 N Greene St (Lower level), Baltimore, MD 21201
    • ,
  • Peter H. Gorman, MD

      Affiliations

    • Department of Neurology, University of Maryland School of Medicine, Baltimore, MD
    • ,
  • Mitchell T. Wallin, MD

      Affiliations

    • Department of Neurology Georgetown University School of Medicine and VA Medical Center, Washington, DC.
    • ,
  • Kristen Kreisel, MS

      Affiliations

    • Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
    • ,
  • Simone Shurland, MS

      Affiliations

    • Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
    • ,
  • Judith A. Johnson, PhD

      Affiliations

    • VA Maryland Health Care System, Baltimore, MD
    • Department of Pathology, University of Maryland School of Medicine, Baltimore, MD

Abstract 

Roghmann M-C, Gorman PH, Wallin MT, Kreisel K, Shurland S, Johnson JA. Staphylococcus aureus colonization in community-dwelling people with spinal cord dysfunction.

Objectives

To estimate the prevalence of and determine risk factors for Staphylococcus aureus colonization of the perineum.

Design

Cross-sectional study with follow-up of up to 1 year.

Setting

Multiple outpatient sites.

Participants

Eighty-four community-dwelling adults with spinal cord dysfunction (SCD).

Interventions

Not applicable.

Main Outcome Measure

Colonization of perineum with S. aureus.

Results

Overall, 24% of the study cohort carried S. aureus on their perineal skin at enrollment, with 16% having methicillin-susceptible S. aureus and 10% having methicillin-resistant S. aureus (MRSA). Most perineal carriers were also colonized in the anterior nares. Participants with trauma as the cause of their SCD were more likely to be colonized with S. aureus than participants with SCD caused by multiple sclerosis or other causes (relative risk [RR], 2.8; 95% confidence interval [CI], 1.2–6.6; P=.01). Participants with pelvic decubiti were more likely to be colonized with S. aureus than participants without pelvic decubiti (RR=4.3; 95% CI, 2.4–7.7; P<.001). The recent use of any antibiotic was not associated with an increased risk of colonization with S. aureus (RR=1.5; 95% CI, 0.7–3.3; P=.31); however, recent fluoroquinolone use was significantly associated with perineal colonization (RR=2.8; 95% CI, 1.4–5.8; P=.02). Of the 8 participants with MRSA colonization, only 2 (25%) had a history of MRSA colonization.

Conclusions

S. aureus colonization of the perineum is common in this outpatient population of people with SCD. The use of fluoroquinolones was associated with S. aureus colonization. Colonization with MRSA without a history of MRSA was common.

Key Words: Cross-sectional studies, Fluoroquinolones, Multiple sclerosis, Rehabilitation, Spinal cord injuries, Staphylococcus aureus

 

 Supported by a VA Merit Review Grant, University of Maryland School of Medicine General Clinical Research Center (grant no. M01-RR-16500), and a Merck Medical School Grant.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

 Reprints are not available from the author.

PII: S0003-9993(07)00348-6

doi:10.1016/j.apmr.2007.05.005

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 8 , Pages 979-983, August 2007

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