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 I year. Setting: Multiple outpatient sites. Participants: Eighty-four community-dwelling adults with spinal cord dysfunction (SCD). Interventions: Not applicable. Main Outcome Measure: Colonization of perineurn 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 perineurn 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.