Prevalence of S aureus in nose and on (un)affected skin of patients visiting the outpatient department of Dermatology.

Staphylococcus aureus is one of the most common causative agent of infections
of the skin and soft tissues. S aureus is present in approximately 30% of all
healthy individuals (= staphylococcus carrier), mostly in the nose and on the
skin. When the immune system is impaired or when catheters or infusions are
being used, S aureus can cause (severe) infections. In 1940 penicillin was
introduced as an effective treatment for S aureus. But quickly S aureus became
resistent. In 1959 methicillin was introduced to solve the resistence problem.
However within a year time S aureus also became resistent for methicillin. Ever
since, the prevalence of (resistent) S aureus worldwide keeps increasing and it
is more frequently found as a cause for infections in hospitals and
nursinghomes. Furthermore, their resistance to various groups of antibiotics is
increasing.

Possibly, patients with skin problems form a risk group for carrying this
bacteria. Therefore, in this research the prevalence and antibiotic sensitivity
of Staphylococcus aureus in patients visiting the outpatient department of
Dermatology will be studied.

1) To determine the prevalence and the sensitivity for various antibiotics of
Staphylococcus aureus in the nose (carrier) of patients visiting the outpatient
department of Dermatology.
2) To determine the prevalence and the sensitivity for various antibiotics of
Staphylococcus aureus as a causative agent for the skin laesion.
3) To determine the prevalence and the sensitivity for various antibiotics of
Staphylococcus aureus found on unaffected skin in patients visiting the
outpatient department of Dermatology.

While visiting the outpatient department of Dermatology in the academic
hospital of Maastricht (AzM) during the research period (December 2007-March
2008), patients will be asked to participate. A population of 300 persons wil
be aimed for. Patients of 18 years and older who have given their written
consent after being well informed, will be included. The patients will be asked
to fill in a questionary and subsequently three swabs samples will be taken by
means of brushing three cottontips on the skinlaesion, one on the unaffected
skin of the upper arm and one in the anterior part of the nose. The material
will be handled anonymously. They will be processed to establish the possible
presence of s aureus. If present, sensitivity for various antibiotics will be
determined. The results will be linked to the patientnumber.

The extent of the burden that goes together with participation, consist of
approximately ten minutes, in which patients will be asked to fill in a
questionnaire and to undergo three swab samples being taken (nose, upper arm
and skin laesion) by means of cottontips. It concerns a single patient contact.
There is no risk associated with participation.