Nose Picking and Nasal Carriage of Staphylococcus aureus
Wertheim HFL., Kleef MV., Vos MC., Ott A., Verbrugh HA., Fokkens W.
<jats:sec id="S0899823X00196126_abs1"><jats:title>Objective.</jats:title><jats:p>Nasal carriage of<jats:italic>Staphylococcus aureus</jats:italic>is an important risk factor for<jats:italic>S. aureus</jats:italic>infection and a reservoir for methicillin-resistant<jats:italic>S. aureus</jats:italic>. We investigated whether nose picking was among the determinants of<jats:italic>S. aureus</jats:italic>nasal carriage.</jats:p></jats:sec><jats:sec id="S0899823X00196126_abs2"><jats:title>Setting and Participants.</jats:title><jats:p>The study cohort comprised 238 patients who visited the ear, nose, and throat (ENT) disease outpatient clinic of a tertiary care hospital and did not have a nose-specific complaint (defined as ENT patients) and 86 healthy hospital employees (including medical students and laboratory personnel).</jats:p></jats:sec><jats:sec id="S0899823X00196126_abs3"><jats:title>Measurements.</jats:title><jats:p>All participants completed a questionnaire on behavior regarding the nose and were screened for<jats:italic>S. aureus</jats:italic>nasal carriage; only ENT patients underwent nasal examination by an ear, nose, and throat physician for clinical signs of nose picking.</jats:p></jats:sec><jats:sec id="S0899823X00196126_abs4"><jats:title>Results.</jats:title><jats:p>Among ENT patients, nose pickers were significantly more likely than non–nose pickers to carry<jats:italic>S. aureus</jats:italic>(37 [53.6%] of 69 vs 60 [35.5%] of 169 patients; relative risk, 1.51 [95% confidence interval, 1.03-2.19]). Among healthy volunteers, there was a statistically significant positive correlation between the self-perceived frequency of nose picking and both the frequency of positive culture results (<jats:italic>R</jats:italic>= 0.31;<jats:italic>P</jats:italic>= .004) and the load of<jats:italic>S. aureus</jats:italic>present in the nose (<jats:italic>R</jats:italic>= 0.32;<jats:italic>P</jats:italic>= .003).</jats:p></jats:sec><jats:sec id="S0899823X00196126_abs5"><jats:title>Conclusion.</jats:title><jats:p>Nose picking is associated with<jats:italic>S. aureus</jats:italic>nasal carriage. The role of nose picking in nasal carriage may well be causal in certain cases. Overcoming the habit of nose picking may aid<jats:italic>S. aureus</jats:italic>decolonization strategies.</jats:p></jats:sec>