Prevalence of Staphylococcus aureus nasal colonization in the United States, 2001-2002

J Infect Dis. 2006 Jan 15;193(2):172-9. doi: 10.1086/499632. Epub 2005 Dec 15.

Abstract

Background: Staphylococcus aureus is a common cause of disease, particularly in colonized persons. Although methicillin-resistant S. aureus (MRSA) infection has become increasingly reported, population-based S. aureus and MRSA colonization estimates are lacking.

Methods: Nasal samples for S. aureus culture and sociodemographic data were obtained from 9622 persons > or = 1 year old as part of the National Health and Nutrition Examination Survey, 2001-2002. After screening for oxacillin susceptibility, MRSA and selected methicillin-susceptible S. aureus isolates were tested for antimicrobial susceptibility, pulsed-field gel electrophoresis clonal type, toxin genes (e.g., for Panton-Valentine leukocidin [PVL]), and staphylococcal cassette chromosome mec (SCCmec) type I-IV genes.

Results: For 2001-2002, national S. aureus and MRSA colonization prevalence estimates were 32.4% (95% confidence interval [CI], 30.7%-34.1%) and 0.8% (95% CI, 0.4%-1.4%), respectively, and population estimates were 89.4 million persons (95% CI, 84.8-94.1 million persons) and 2.3 million persons (95% CI, 1.2-3.8 million persons), respectively. S. aureus colonization prevalence was highest in participants 6-11 years old. MRSA colonization was associated with age > or = 60 years and being female but not with recent health-care exposure. In unweighted analyses, the SCCmec type IV gene was more frequent in isolates from participants of younger age and of non-Hispanic black race/ethnicity; the PVL gene was present in 9 (2.4%) of 372 of isolates tested.

Conclusions: Many persons in the United States are colonized with S. aureus; prevalence rates differ demographically. MRSA colonization prevalence, although low nationally in 2001-2002, may vary with demographic and organism characteristics.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Bacterial Toxins / genetics
  • Carrier State / epidemiology
  • Carrier State / microbiology*
  • Child
  • Child, Preschool
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology*
  • DNA Fingerprinting
  • DNA, Bacterial / analysis
  • DNA, Bacterial / genetics
  • Electrophoresis, Gel, Pulsed-Field
  • Ethnic Groups
  • Female
  • Humans
  • Infant
  • Male
  • Methicillin Resistance*
  • Microbial Sensitivity Tests
  • Middle Aged
  • Molecular Epidemiology
  • Nose / microbiology*
  • Prevalence
  • Sex Factors
  • Socioeconomic Factors
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / classification
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / growth & development*
  • Staphylococcus aureus / isolation & purification
  • United States

Substances

  • Bacterial Toxins
  • DNA, Bacterial