Intestinal carriage of Staphylococcus aureus : how does its frequency compare with that of nasal carriage and what is its clinical impact?

Author： Acton D.

Publisher： Springer Publishing Company

ISSN： 0934-9723

Source： European Journal of Clinical Microbiology and Infectious Diseases, Vol.28, Iss.2, 2009-02, pp. : 115-127

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Abstract

The bacterial species Staphylococcus aureus</i>, including its methicillin-resistant variant (MRSA), finds its primary ecological niche in the human nose, but is also able to colonize the intestines and the perineal region. Intestinal carriage has not been widely investigated despite its potential clinical impact. This review summarizes literature on the topic and sketches the current state of affairs from a microbiological and infectious diseases' perspective. Major findings are that the average reported detection rate of intestinal carriage in healthy individuals and patients is 20% for S. aureus</i> and 9% for MRSA, which is approximately half of that for nasal carriage. Nasal carriage seems to predispose to intestinal carriage, but sole intestinal carriage occurs relatively frequently and is observed in 1 out of 3 intestinal carriers, which provides a rationale to include intestinal screening for surveillance or in outbreak settings. Colonization of the intestinal tract with S. aureus</i> at a young age occurs at a high frequency and may affect the host's immune system. The frequency of intestinal carriage is generally underestimated and may significantly contribute to bacterial dissemination and subsequent risk of infections. Whether intestinal rather than nasal S. aureus</i> carriage is a primary predictor for infections is still ill-defined.