Staphylococcus aureus Colonization in Community-Dwelling People With Spinal Cord Dysfunction
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.
bDepartment of Neurology, University of Maryland School of Medicine, Baltimore, MD
cDepartment of Pathology, University of Maryland School of Medicine, Baltimore, MD
dDepartment of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
eDepartment of Neurology Georgetown University School of Medicine and VA Medical Center, Washington, DC.
Correspondence to Mary-Claire Roghmann, MD, MS, 100 N Greene St (Lower level), Baltimore, MD 21201
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.
ABSTRACT