Risk factors for persistent Staphylococcus aureus nasal carriage in the community
Abstract Staphylococcus aureus is a major human pathogen and commensal of the nose and other body sites. S. aureus colonisation (carriage) increases the risk of infection, so identifying carriers is central to infection control; however, few studies have combined robust methods with sufficient statistical power to determine the risk factors for carriage. We recruited over 22,000 adults into the CARRIAGE cohort study, who each returned self-taken nasal swabs and a questionnaire weekly for three weeks. We show that in a multivariable analysis with correction for multiple testing that the only factors significantly associated with persistent S. aureus carriage were younger age (with carriage rates declining after 60), male sex, higher BMI, chronic skin conditions, and antibiotic use in the prior month. Many previously proposed factors, including smoking and livestock contact, were not significantly associated. Overall, we demonstrate that only a limited number of risk factors influence S. aureus colonisation
Authors
- Asha Akram
- Carmel S. Moore (ORCID: https://orcid.org/0000-0002-2386-7200)
- Joan A. Geoghegan (ORCID: https://orcid.org/0000-0002-3788-0668)
- Emanuele Di Angelantonio (ORCID: https://orcid.org/0000-0001-8776-6719)
- Sharon J. Peacock (ORCID: https://orcid.org/0000-0002-1718-2782)
- Katie Bellis (ORCID: https://orcid.org/0000-0001-5368-7027)
- Shannon Duthie
- Susan Burton (ORCID: https://orcid.org/0000-0002-3747-4870)
- Annie Fletcher
- Catarina Sousa (ORCID: https://orcid.org/0000-0003-1709-6283)
- Ellena Brooks
- Beth Blane (ORCID: https://orcid.org/0000-0002-0996-9091)
- Carol M. Churcher
- Marta Matuszewska (ORCID: https://orcid.org/0000-0002-2653-7725)
- Elisha Johnson
- Dinesh Aggarwal (ORCID: https://orcid.org/0000-0002-5938-8172)
- Toska Wonfor
- Ewan M. Harrison (ORCID: https://orcid.org/0000-0003-2720-0507)
- Sophia T. Girgis (ORCID: https://orcid.org/0009-0003-2368-0432)
- Joe Brennan
- Plamena Naydenova (ORCID: https://orcid.org/0009-0009-7839-7654)
- Stephen K. Kaptoge (ORCID: https://orcid.org/0000-0002-1155-4872)
- Julian Parkhill (ORCID: https://orcid.org/0000-0002-7069-5958)
- Adam S. Butterworth (ORCID: https://orcid.org/0000-0002-6915-9015)
- Rachel Henry
- Matthew R. Walker (ORCID: https://orcid.org/0000-0002-6334-2732)
- Hannah Dingwall
- Lauma Sarkane
- Ben Hyatt (ORCID: https://orcid.org/0009-0002-3741-1391)
- Svetlana Shadrina
- Agnieszka Osmanska
- Neenu Linson
- James Groom
- Emma Fraser
- Benjamin McCarthy
- Kathy Raven
- Jess Middlemiss
- Nashma Pelamkulangara
- John Danesh
- Carl Anderson
- Catherine Perry
- Duncan Ng
- Róisín Boggan
- Amy Mc Mahon
Institutions
- University of Cambridge (GB)
- Wellcome Sanger Institute (GB)
- Imperial College London (GB)
- University of Birmingham (GB)
Publication Details
- Journal
- Research Square
- Published
- 2026-11-02
- DOI
- https://doi.org/10.21203/rs.3.rs-11390307/v1
- Primary Topic
- Antimicrobial Resistance in Staphylococcus
- Type
- preprint
Funders
- NHS Blood and Transplant
- UK Research and Innovation
- National Institute for Health and Care Research
- British Heart Foundation
- Department of Health and Social Care
- Public Health Agency
- Isaac Newton Trust
- Chief Scientist Office, Scottish Government Health and Social Care Directorate
- NIHR BioResource
- Medical Research Council
- Engineering and Physical Sciences Research Council
- Economic and Social Research Council
- Health and Social Care Research and Development Division
- NIHR Cambridge Biomedical Research Centre
- Health Data Research UK