Staphylococcus aureus carriage among GPs in the Netherlands

Background The extent to which GPs serve as a reservoir for antibiotic-resistant Staphylococcus aureus is unknown and not well studied. Aim To determine the prevalence of nasal S. aureus carnage among GPs in the Netherlands, as well as the antimicrobial resistance and the genotypes of isolated S. aureus. Design of study Observational, point-prevalence, and cross-sectional study. Setting GPs attending the annual conference of the Dutch College of General. Practitioners in 2006. Method Nasal swabs were randomly taken from 395 GPs and analysed for the presence of S. aureus. Antimicrobial susceptibility was determined by a microbroth dilution method and the genotypes by spa typing, which was. associated with multilocus sequence typing. Results Of the GPs, 129/395 (33%; 95% confidence interval, [CI] = 28 to 37%) were carriers of S. aureus. No meticillin-resistant S. aureus (MRSA) was found. Resistance was observed to penicillin (71%; 95% CI = 63 to 79%), fusidic acid (7%; 95% CI = 3 to 13%), and clarithromycin (6%; 95% CI = 3 to 12%). In 72% of the isolates, an MRSA-related genotype of S. aureus was found. Conclusion The low antibiotic resistance found among S. aureus of GPs suggests that GPs are not a reservoir of antibiotic-resistant S. aureus strains. The relatively high resistance to fusidic acid, which has not previously been described in the Netherlands and is mostly because of antibiotic use, suggests that patients infect GPs and not the other way round. GPs may be at risk for nasal carriage of S. aureus with an MRSA-related genotype.