Neglect of skin wounds and the risk of becoming a Staphylococcus aureus nasal carrier: a cohort study

BMC Public Health

Research Article

Hagai Levine¹  Raid Kayouf²  Vladislav Rozhavski²  Tami Halperin²  Shiraz Yona²  Tamar Sela²  Olga Gorochovski²  Anat Tzurel Ferber²  Inbal Rajuan-Galor²  Michael Hartal³ 

[1] Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel;Israel Defence Forces Medical Corps, Tel Hashomer, Israel;Israel Defence Forces Medical Corps, Tel Hashomer, Israel;Israel Defence Forces Medical Corps, Tel Hashomer, Israel;Department of Military Medicine, Hebrew University Faculty of Medicine, Jerusalem, Israel;

关键词: Prevention;    Epidemiology;    Wounds;    Skin and Soft tissue infections;    Staphylococcus aureus;    Carriage;    Young adults;    Behavioral determinants;   

DOI  :  10.1186/s12889-015-2104-8

 received in 2015-01-31, accepted in 2015-07-28,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundNasal carriers of Staphylococcus aureus have an increased risk of acquiring skin and soft tissue infections, which could manifest as outbreaks, especially in crowded settings. Current prevention programs are ineffective, antibiotic resistance is rising and risk factors for becoming a carrier are incompletely understood. We aimed to examine whether a behavior, the neglect of skin wounds, is a risk factor for becoming a Staphylococcus aureus carrier during training.MethodsWe conducted a field-based cohort study among male infantry trainees in three seasons in Israel during 2011–12. Participants underwent anterior nares cultures and answered structured questionnaires on potential risk factors on two occasions: before and 3 weeks after start of training (N = 542). Attitudes and practices toward neglect of skin wounds were defined as perseverance in training at all costs, despite having a wound. Samples were processed within 18 hours for identification of Staphylococcus aureus. Univariable and multivariable logistic regression analyses were performed to assess risk factors for becoming a carrier.ResultsCarriage prevalence increased by 43.3 % during training, from 33.2 % to 47.6 % (p < 0.01). One-fourth (25.4 %) of those with a negative culture before training became carriers. None of the socio-demographic characteristics was a risk factor for becoming a carrier while the risk was lower in the winter (Odds ratio [OR] = 0.42; 95 % confidence interval [CI]: 0.23-0.78, p < 0.01) and spring (OR = 0.46; 0.26-0.81, p < 0.01) seasons compared to the summer season. Neglect of skin wounds in practice and attitude was a risk factor for becoming a carrier (OR = 2.40; 1.13-5.12, p = 0.02), as well as neglect in practice or attitude (OR = 1.86; 1.04-3.34, p = 0.04) compared to no neglect when controlled for season. The preventable fraction in the population attributed to neglect of skin wounds was 33 %.ConclusionsNeglect of skin wounds is an independent, common and strong risk factor for becoming a Staphylococcus aureus carrier during training. This preventable behavior should not be ignored and should be addressed in public health programs during training and in other settings. Further research on behavioral determinants of Staphylococcus aureus carriage and infection is warranted.

【 授权许可】

CC BY   
© Levine et al. 2015