Content area
Full text
Clin Oral Invest (2009) 13:369373
DOI 10.1007/s00784-008-0244-2
ORIGINAL ARTICLE
Methicillin-resistant Staphylococcus aureus (MRSA) among dental patients: a problem for infection control in dentistry?
Melanie Zimmerli & Andreas F. Widmer & Marc Dangel &
Andreas Filippi & Reno Frei & Jrg Meyer
Received: 15 September 2008 /Accepted: 8 December 2008 /Published online: 23 December 2008 # Springer-Verlag 2008
Abstract We assessed the frequency of carriers of methicillin-resistant Staphylococcus aureus (MRSA) among 500 dental patients of a university clinic. From each participant, two specimens were taken from the anterior nares and the pharynx and analysed by culture. The participants completed a questionnaire on possible risk factors of MRSA infection. Two hundred ten individuals carried S. aureus, 90 in the nares only, 51 in the throat only and 69 in nares and throat. Isolates of 208 patients were methicillin-sensitive; two isolates were methicillin-resistant, both carried in the throat exclusively. In conclusion, the frequency of nasal and/or throat carriers of MRSA among dental patients was low and suggests few opportunities of exposure in the dental clinic assessed.
Keywords Staphylococcus aureus . Methicillin resistance .
MRSA carriers . Epidemiology. Infection control
Introduction
Staphylococcus aureus is an important bacterial pathogen causing a wide variety of infections ranging from mild local infections of skin and soft tissue to severe systemic infections such as sepsis and toxic shock syndrome, which may be lethal. Typically, this bacterium lives as a commensal in the nose and/or throat of 20% to 70% of adults [17, 31]. Methicillin-resistant S. aureus (MRSA) which are generally resistant to multiple antibiotics have emerged among persons in hospitals, nursing homes and other health care institutions since the 1960s and are called hospital- or health care-associated MRSA (HA-MRSA) [2]. They account for a large part of nosocomial infections worldwide [29, 33] and are associated with longer hospital-isation and higher lethality [37]. Most of these nosocomial infections are caused by few successful epidemic clones of HA-MRSA [20].
In the community setting, several outbreaks of severe infections with MRSA have been reported among people lacking established risk factors for HA-MRSA acquisition [6]. The bacteria are referred to as community-associated MRSA (CA-MRSA) and differ from HA-MRSA in several important aspects [9, 44]. First reported in the 1980s, these CA-MRSA infections seem to have increased...