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Journal of Clinical Microbiology, October 1999, p. 3133-3140, Vol. 37, No. 10
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Follow-Up of Staphylococcus aureus Nasal Carriage after 8 Years: Redefining the Persistent Carrier State

Marjolein F. Q. VandenBergh,* Ed P. F. Yzerman,dagger Alex van Belkum, Hélène A. M. Boelens, Marly Sijmons, and Henri A. Verbrugh

Department of Medical Microbiology & Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands

Received 23 December 1998/Returned for modification 27 February 1999/Accepted 14 July 1999

Studies of Staphylococcus aureus nasal carriage have distinguished three carriage patterns: persistent, intermittent, and noncarriage. The criteria used to identify these carriage patterns have been inconsistent. In 1988 the S. aureus nasal carrier index, i.e., the proportion of nasal swab specimen cultures yielding S. aureus, was determined for 91 staff members of various departments of a large university hospital by obtaining weekly nasal swab specimens for culture over a 12-week period. Thirty-three (36%) persons had carrier indices of 0.80 or higher, 15 (17%) had indices between 0.1 and 0.7, and 43 (47%) had indices of zero. In 1995, 17 individuals with carrier indices of 0.80 or higher in 1988 were available for reexamination. For 12 (71%) of these individuals, S. aureus was again isolated from a single nasal swab, i.e., from each individual with a 1988 carrier index of 1.0 but from only half of those with indices below 1.0. Genotyping (by randomly amplified polymorphic DNA analysis and pulsed-field gel electrophoresis) of all S. aureus strains showed that strains isolated from only three individuals, all with 1988 carrier indices of 1.0, in 1988 and 1995 showed genetic similarity. In conclusion, persistent S. aureus nasal carriage is a unique characteristic of a fraction of the population, and the attribute "persistent" should be confined to those individuals for whom serial nasal swab specimen cultures consistently yield S. aureus.

* Corresponding author. Present address: Department of Medical Microbiology, University Hospital Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Phone: (31) 24 3614369. Fax: (31) 24 3540216. E-mail: m.vandenbergh{at}mmb.azn.nl.

dagger Present address: Regional Public Health Laboratory, Haarlem, The Netherlands.

Journal of Clinical Microbiology, October 1999, p. 3133-3140, Vol. 37, No. 10
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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