TY - JOUR
T1 - The Risk of Infection after Nasal Colonization with Staphylococcus Aureus
AU - Safdar, Nasia
AU - Bradley, Elisa A.
N1 - Funding Information:
Supported by a Society of Critical Care Medicine Vision Grant (NS). Dr. Safdar was also supported by an institutional K-12 training grant from the Institute of Aging, National Institutes of Health, Bethesda, Md.
PY - 2008/4
Y1 - 2008/4
N2 - Purpose: Nasal, axillary, or inguinal colonization with Staphylococcus aureus generally precedes invasive infection. Some studies have found that colonization with methicillin-resistant S. aureus (MRSA) poses a greater risk of clinical infection than colonization with methicillin-susceptible S. aureus (MSSA). However, the magnitude of risk is unclear. Methods: We undertook a systematic review to provide an overall estimate of the risk of infection following colonization with MRSA compared with colonization by MSSA. Ten observational studies, with a total of 1170 patients, were identified that provided data on both MSSA and MRSA colonization and infection. A random-effects model was used to obtain pooled estimates of the odds ratio and 95% confidence interval. Results: Overall, colonization by MRSA was associated with a 4-fold increase in the risk of infection (odds ratio 4.08, 95% confidence interval, 2.10-7.44). Studies differed in the choice of patient population, severity of illness, and frequency of sampling to detect colonization. Conclusion: Further research is needed to identify effective methods for sustained eradication of MRSA carriage to reduce the high risk of subsequent infection.
AB - Purpose: Nasal, axillary, or inguinal colonization with Staphylococcus aureus generally precedes invasive infection. Some studies have found that colonization with methicillin-resistant S. aureus (MRSA) poses a greater risk of clinical infection than colonization with methicillin-susceptible S. aureus (MSSA). However, the magnitude of risk is unclear. Methods: We undertook a systematic review to provide an overall estimate of the risk of infection following colonization with MRSA compared with colonization by MSSA. Ten observational studies, with a total of 1170 patients, were identified that provided data on both MSSA and MRSA colonization and infection. A random-effects model was used to obtain pooled estimates of the odds ratio and 95% confidence interval. Results: Overall, colonization by MRSA was associated with a 4-fold increase in the risk of infection (odds ratio 4.08, 95% confidence interval, 2.10-7.44). Studies differed in the choice of patient population, severity of illness, and frequency of sampling to detect colonization. Conclusion: Further research is needed to identify effective methods for sustained eradication of MRSA carriage to reduce the high risk of subsequent infection.
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U2 - 10.1016/j.amjmed.2007.07.034
DO - 10.1016/j.amjmed.2007.07.034
M3 - Review article
C2 - 18374690
AN - SCOPUS:40949105927
VL - 121
SP - 310
EP - 315
JO - American Journal of Medicine
JF - American Journal of Medicine
SN - 0002-9343
IS - 4
ER -