caa a22 4500 388033118 CHVBK 20180307124957.0 cr unu---uuuuu 161130e199805 xx s 000 0 eng 10.1086/647823 doi S0195941700087609 pii (NATIONALLICENCE)cambridge-10.1086/647823 Staphylococcus aureus Nasal Colonization in Patients with Cirrhosis: Prospective Assessment of Association with Infection [Elektronische Daten] OBJECTIVE: To determine if Staphylococcus aureus colonization of the anterior nares was a risk factor for S aureus infection in patients with cirrhosis and to determine the predictors of S aureus infection in colonized patients. DESIGN: Prospective cohort study. PATIENTS: 84 consecutive patients with cirrhosis admitted to the liver transplant unit of a university-affiliated Veterans' Affairs Medical Center. RESULTS: Overall, 39 (46%) of the 84 patients were nasal carriers of S aureus, of which 24 (29%) were methicillin-resistant Staphylococcus aureus (MRSA) and 15 (18%) were methicillin-sensitive Staphylococcus aureus (MSSA). Only MRSA, but never MSSA, carriage was acquired in the hospital; all 15 of the MSSA versus 14 (58%) of the 24 MRSA carriers were nasal carriers on first (admission) culture (P=.001). Of the 10 (42%) of 24 MRSA carriers who were not colonized on admission, 3 became MRSA carriers within 1 month, and 7 acquired MRSA carriage more than a month later. Higher Child-Pugh score was independently associated with MRSA carriage (odds ratio [OR], 1.54; 95% confidence interval [CI95], 1.1-2.3). S aureus nasal carriers (9 [23%] of 39) were significantly more likely to develop S aureus infections than noncarriers (2 [4%] of 45; P=.02). Central venous catheter use was associated independently with S aureus infections in the carriers (OR, 4.1; CI95, 2.8-6.1). Mortality was significantly higher in carriers who developed S aureus infections as compared to those who did not (57% vs 13%; P=.022); S aureus infection was an independent predictor of mortality in the carriers (OR, 8.7; CI95, 1.2-63.8). CONCLUSIONS: Colonization of the anterior nares was a significant predictor of S aureus infection in patients with cirrhosis Copyright © The Society for Healthcare Epidemiology of America 1998 Chang Feng Yee Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania Singh Nina Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania Gayowski Timothy Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania Wagener Marilyn M. Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania Marino Ignazio R. Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania Infection Control & Hospital Epidemiology Cambridge University Press 19/5(1998-05), 328-332 0899-823X 19:5<328 1998 19 ICE https://doi.org/10.1086/647823 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1086/647823 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chang Feng Yee Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania NATIONALLICENCE 700 1- Singh Nina Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania NATIONALLICENCE 700 1- Gayowski Timothy Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania NATIONALLICENCE 700 1- Wagener Marilyn M. Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania NATIONALLICENCE 700 1- Marino Ignazio R. Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania NATIONALLICENCE 773 0- Infection Control & Hospital Epidemiology Cambridge University Press 19/5(1998-05), 328-332 0899-823X 19:5<328 1998 19 ICE CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge