Staphylococcus aureus colonization in community-dwelling people with spinal cord dysfunction.

OBJECTIVES

To estimate the prevalence of and determine risk factors for Staphylococcus aureus colonization of the perineum.

DESIGN

Cross-sectional study with follow-up of up to 1 year.

SETTING

Multiple outpatient sites.

PARTICIPANTS

Eighty-four community-dwelling adults with spinal cord dysfunction (SCD).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURE: Colonization of perineum with S. aureus.

RESULTS

Overall, 24% of the study cohort carried S. aureus on their perineal skin at enrollment, with 16% having methicillin-susceptible S. aureus and 10% having methicillin-resistant S. aureus (MRSA). Most perineal carriers were also colonized in the anterior nares. Participants with trauma as the cause of their SCD were more likely to be colonized with S. aureus than participants with SCD caused by multiple sclerosis or other causes (relative risk [RR], 2.8; 95% confidence interval [CI], 1.2-6.6; P=.01). Participants with pelvic decubiti were more likely to be colonized with S. aureus than participants without pelvic decubiti (RR=4.3; 95% CI, 2.4-7.7; P<.001). The recent use of any antibiotic was not associated with an increased risk of colonization with S. aureus (RR=1.5; 95% CI, 0.7-3.3; P=.31); however, recent fluoroquinolone use was significantly associated with perineal colonization (RR=2.8; 95% CI, 1.4-5.8; P=.02). Of the 8 participants with MRSA colonization, only 2 (25%) had a history of MRSA colonization.

CONCLUSIONS

S. aureus colonization of the perineum is common in this outpatient population of people with SCD. The use of fluoroquinolones was associated with S. aureus colonization. Colonization with MRSA without a history of MRSA was common.