The carriage of Staphylococcus pyogenes var. aureus in the human nose

Abstract

Over 500 medical students have been examined for nasal carriage of Staph. pyogenes at weekly intervals over a period ranging from 3 to 12 months.Nasal carriers were classified as persistent, intermittent and occasional. Of the students, 39% were persistent or intermittent carriers in whom the staphylococcus was believed to colonize the skin of the vestibule of the nose; 42% were occasional carriers in whom the staphylococcus was only a chance inhabitant of the nares.Staph. pyogenes was isolated from the anterior nares of persistent carriers on at least 90% of the occasions on which they were examined, and was of the same phage type on each occasion. From intermittent carriers it was isolated less regularly, but on at least 10% of occasions on which they were examined, and it remained of one phage type. Staph. pyogenes was isolated at less than 10% of swabbings from occasional carriers, and at each the organism was of a different phage type.Eighty-nine per cent of persistent and intermittent carrier strains, and 54% of occasional carrier strains could be typed with phage filtrates. The strains not typable with phage filtrates, and found predominantly among occasional carriers, were considered worthy of separate classification, and it is suggested that typability with phage be used as a criterion of pathogenicity for Staph. pyogenes.We wish to thank Prof. T. J. Mackie for his continued interest and advice; Dr J. P. Duguid for criticism and advice; Dr R. E. O. Williams and Miss Joan Rippon of the Staphylococcal Reference Laboratory, Colindale, who very kindly instructed one of us (J.C.G.) in bacteriophage typing; Dr Donald Cruickshank for taking nasal swabs from patients; Dr Cumming of the Blood Transfusion Department, Royal Infirmary, Edinburgh, for permission to swab blood donors, and the medical students who so willingly co-operated in this work.

Staphylococcal epidemiology in Antarctica

“…The Mawson results tend to confirm Sladen's proposal that there is a low incidence of occasional carriers in Antarctica, compared with temperate climates, when from 40 % (Gould & McKillop, 1954) to 60 % (Hutchinson, Green & Grimson, 1957) of a normal population will be found to carry staphylococci for short periods if observed over several months. The relative protective effect of an established coagulase-negative population in the anterior nares (Shinefield, Ribble, Boris & Eichenwald, 1963) was the only other persistent carrier of S. aureus on this trip, and he retained his type 52 strain.…”

“…Subject 3 could be classed as an intermittent carrier, losing his nasal strain for at least 5 months and resuming with a different organism. Though some men (subjects 11, 12 and 16) did not carry their nasal strains for the complete study period, their pattern of constant carriage of organisms of similar phage type for over 9 months allows their inclusion in the category of persistent carriers (Gould & McKillop, 1954). The remaining nasal carriers were persistent carriers of S. aureus with similar phage types at each collection, except subject 13, who changed from type 52 to type 6 during June, and who carried the latter strain for the rest of the year.…”

Infection control of Staphylococcus aureus : spa typing to elucidate transmission

“…By including screening cultures from the throat the sensitivity of detecting colonization significantly increases and it has therefore been suggested that S. aureus screening programs should include sampling of the anterior nares as well as the throat (Mertz et al 2007). Other anatomical sites, e.g., the axilla, groin, skin and the intestinal tract, are also colonized with S. aureus (Acton et al 2009;Vento et al 2013) S. aureus nasal carriers are usually divided into three distinct groups (Gould & McKillop 1954;Kluytmans et al 1997). …”

Staphylococcal nasal carriage in mothers, babies and staff in a maternity hospital

“…These were considered to be carriers since swabs prior to and subsequent to admission both gave a coagulase positive staphylococcus of identical phage and antibiotic sensitivity type, and in many cases the infant also became a carrier of this strain. These cases undoubtedly belong to the class of intermittent carriers described by Gould & McKillop (1954). A population 18 K. F. ANDERSON, J. R. COULTER AND D. RUTH KEYNES was divided into three groups by these workers; the staphylococcal carriers, the non-carriers and the intermittent carriers.…”