- NEW YORK (Reuters
Health) - Staphylococcus aureus bacteria that live in the nose can enter
the bloodstream and cause serious, life-threatening infections in some
people, researchers report.
- S. aureus is one of the most common causes of serious
infections that patients acquire while hospitalized, and previous studies
have linked the presence of the bacteria in the nose to the risk of such
infections. About 60% of people in the population carry the bacteria in
their nose at one time or another, and it is usually symptomless.
- However, a new study of 219 hospital patients with infections
involving S. aureus found that in 82% of cases, the bacteria invading the
blood were identical to the bacteria in the patient's nose. The more invasive
infections got their start in a number of different ways, including the
use of a catheter or the development of skin or respiratory infections.
- In a separate analysis of 1,278 hospital patients known
to have S. aureus living in the nose, 12 people eventually developed serious
blood infections with S. aureus that exactly matched the type of bacteria
seen in their nose. The findings are published in the January 4th issue
of The New England Journal of Medicine.
- Based on these findings, Dr. Christof von Eiff from the
University of Munster, Germany, and colleagues conclude that eliminating
the bacteria from the nose of hospital patients might prevent serious infections
by these same bacteria.
- However, this may not be as easy as it sounds, Dr. Gordon
L. Archer, of the Medical College of Virginia at Virginia Commonwealth
University in Richmond, told Reuters Health.
- ``The problem is that there is no timely way for identifying
these carriers,'' he said. ``If we had a rapid diagnostic test--like the
one we have for strep throat--then we might be able to identify people
in the hospital with (S. aureus) in their nasal passages and go about eliminating
it before serious infections developed.''
- Also, it is not clear exactly how to get rid of the bacteria
once they are detected, Archer and colleague Dr. Michael Climo note in
an editorial accompanying the study. Oral antibiotics may encourage the
bacteria to become resistant to such drugs. Giving antibiotic ointment
has been unsuccessful or only eradicated the bacteria for short periods
of time, or has resulted in resistant bacteria in areas with heavy usage,
Archer and Climo explain.
- To truly reduce hospital infection due to S. aureus will
require ``aggressive tactics and innovative strategies,'' the editorialists
conclude. And an attack on the bacteria lurking in the nose should ``be
one of the foundations of this program.''
- The study was funded in part by SmithKline Beecham, which
manufacturers an antibiotic ointment.
- SOURCE: The New England Journal of Medicine 2001;344:11-16,
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