The effect of Staphylococcus aureus nasal burden on the incidence of endogenous infection: a single center prospective observational cohort study in tertiary-care – towards decolonization of high-risk patients

金黄色葡萄球菌是医院获得性感染的最重要原因之一，鼻携带者的风险大大增加。尽管甲氧西林敏感金黄色葡萄球菌（MSSA）表现出与其耐甲氧西林对应物（MRSA）相同的毒力和临床影响，但通过筛查和鼻腔去菌落预防感染主要集中在MRSA上。显然，定殖金黄色葡萄球菌的甲氧西林耐药性不是内源性金黄色葡萄球菌感染的最佳预后标志物，因此需要更好的工具来识别高风险患者，从而靶向鼻腔去定殖。此外，更好地界定高危人群将有助于有效地研究疫苗等创新性预防干预措施。本研究旨在评估定量鼻腔金黄色葡萄球菌细菌负担对内源性医院感染发生率的影响，以及在此背景下，在标准化高通量系统上分析单拭子对高危患者选择性去菌落的影响。在抗生素耐药性日益增加的时代，选择性去殖民化将通过减少不必要的使用来促进更负责任的抗生素使用作为感染预防措施，从而减少选择压力并防止耐药性的发展。

Staphylococcus aureus is one of the most significant causes of hospital acquired infections and nasal carriers were found to be at substantially increased risk. Even though methicillin-susceptible S. aureus (MSSA) exhibit the same virulence and clinical impact as their methicillin-resistant counterpart (MRSA), prevention of infection through screening and nasal decolonization has largely focused on MRSA. Clearly, methicillin resistance in colonizing S. aureus is a suboptimal prognostic marker for endogenous S. aureus infection and better tools to identify patients at high risk and thus for targeted nasal decolonization are needed. Besides, better definition of high-risk populations would allow the efficient study of innovative preventive interventions such as vaccines. This study aims to assess the effect of quantitative nasal S. aureus bacterial burden on the incidence of endogenous, nosocomial infections and the use of single-swabs analyzed on a standardised high-throughput system in this context towards selective decolonization of high-risk patients. In the era of increasing antibiotic resistance, selective decolonization would promote a more responsible antibiotic use as infection prevention measures by reducing unnecessary use thus reducing selection pressure and preventing resistance development.