Antibiotic resistance and prevalence of PVL-positive staphylococcus aureus in the nose of unselected patients attending general practitioners in the Netherlands.

Staphylococcus aureus perrnanently or transiently colonizes the anterior nostrils and regions of skin and mucous membranes which rnay act as a source of infection. Examples of such infections are (surgical) wound infections, pneurnonia after a viral respiratory tract infection and necrotizing infections of the lungs. Panton-Valentine Leukocidine (PVL) has been found a virulente factor respbnsible for these necrotizing infections. For the treatment of infections caused by these (PVL-positive) strains flucloxacilline is still the treatment of choice in the Netherlands. However, an increase in the prevalence of antibiotic resistant S. aureus has been observed both in the Netherlands and worldwide. To determine the antibiotic resistance and the prevalence of PVL-positive S. aureus strains a population-based study was conducted among patients attending general practitioners (GPs) from 19 Sentinel Stations of the Netherlands Institute of Health Services Research (NIVEL), without any symptoms of a respiratory tract, skin or wound infection. The preliminary data (1450 swabs) showed a prevalence of S. aureus ranging from 21% to 32%. In all, 2500 swabs wil1 be analysed. The results on the total number of swabs analysed, the prevalente of PVL positive S. aureus isolates and the susceptibility to antibiotics commonly used by GPs including topical agents such as mupirocin and fucidic acid will be presented. These results will support GPs in their optimal empirie choice for the treatment of a staphylococcal infection. In addition, the study may Support the development of evident based guidelines. (aut. ref.