Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 May 15;60(10):1489-96.
doi: 10.1093/cid/civ075. Epub 2015 Feb 3.

Duration of Colonization and Determinants of Earlier Clearance of Colonization With Methicillin-Resistant Staphylococcus aureus

Valerie C Cluzet  1 , Jeffrey S Gerber  2 , Irving Nachamkin  3 , Joshua P Metlay  4 , Theoklis E Zaoutis  2 , Meghan F Davis  5 , Kathleen G Julian  6 , David Royer  7 , Darren R Linkin  8 , Susan E Coffin  2 , David J Margolis  9 , Judd E Hollander  10 , Rakesh D Mistry  11 , Laurence J Gavin  12 , Pam Tolomeo  13 , Jacqueleen A Wise  13 , Mary K Wheeler  13 , Warren B Bilker  14 , Xiaoyan Han  14 , Baofeng Hu  3 , Neil O Fishman  1 , Ebbing Lautenbach  15
Affiliations

Duration of Colonization and Determinants of Earlier Clearance of Colonization With Methicillin-Resistant Staphylococcus aureus

Valerie C Cluzet et al. Clin Infect Dis. .

Abstract

Background: The duration of colonization and factors associated with clearance of methicillin-resistant Staphylococcus aureus (MRSA) after community-onset MRSA skin and soft-tissue infection (SSTI) remain unclear.

Methods: We conducted a prospective cohort study of patients with acute MRSA SSTI presenting to 5 adult and pediatric academic hospitals from 1 January 2010 through 31 December 2012. Index patients and household members performed self-sampling for MRSA colonization every 2 weeks for 6 months. Clearance of colonization was defined as negative MRSA surveillance cultures during 2 consecutive sampling periods. A Cox proportional hazards regression model was developed to identify determinants of clearance of colonization.

Results: Two hundred forty-three index patients were included. The median duration of MRSA colonization after SSTI diagnosis was 21 days (95% confidence interval [CI], 19-24), and 19.8% never cleared colonization. Treatment of the SSTI with clindamycin was associated with earlier clearance (hazard ratio [HR], 1.72; 95% CI, 1.28-2.30; P < .001). Older age (HR, 0.99; 95% CI, .98-1.00; P = .01) was associated with longer duration of colonization. There was a borderline significant association between increased number of household members colonized with MRSA and later clearance of colonization in the index patient (HR, 0.85; 95% CI, .71-1.01; P = .06).

Conclusions: With a systematic, regular sampling protocol, duration of MRSA colonization was noted to be shorter than previously reported, although 19.8% of patients remained colonized at 6 months. The association between clindamycin and shorter duration of colonization after MRSA SSTI suggests a possible role for the antibiotic selected for treatment of MRSA infection.

Keywords: MRSA colonization; MRSA decolonization; MRSA skin and soft-tissue infection; methicillin-resistant Staphylococcus aureus (MRSA).

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flow chart for study subjects. Abbreviation: MRSA, methicillin-resistant Staphylococcus aureus.
Figure 2.
Figure 2.
Kaplan–Meier curve of duration of colonization with methicillin-resistant Staphylococcus aureus (MRSA) after diagnosis and treatment of MRSA skin and soft-tissue infection.
Figure 3.
Figure 3.
Kaplan–Meier curve of duration of colonization with methicillin-resistant Staphylococcus aureus (MRSA) after confirmation of MRSA carriage.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Pfaller MA, Jones RN, Doern GV, Kugler K. Bacterial pathogens isolated from patients with bloodstream infection: frequencies of occurrence and antimicrobial susceptibility patterns from the SENTRY antimicrobial surveillance program (United States and Canada, 1997). Antimicrob Agents Chemother 1998; 42:1762–70. - PMC - PubMed
    1. Zetola N, Francis JS, Nuermberger EL, Bishai WR. Community-acquired meticillin-resistant Staphylococcus aureus: an emerging threat. Lancet Infect Dis 2005; 5:275–86. - PubMed
    1. Salgado CD, Farr BM, Calfee DP. Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin Infect Dis 2003; 36:131–9. - PubMed
    1. Fritz SA, Hogan PG, Hayek G, et al. Staphylococcus aureus colonization in children with community-associated Staphylococcus aureus skin infections and their household contacts. Arch Pediatr Adolesc Med 2012; 166:551–7. - PMC - PubMed
    1. Mollema FP, Richardus JH, Behrendt M, et al. Transmission of methicillin-resistant Staphylococcus aureus to household contacts. J Clin Microbiol 2010; 48:202–7. - PMC - PubMed

Publication types

MeSH terms

Substances