Worsening Glycemia Increases the Odds of Intermittent but Not Persistent Staphylococcus aureus Nasal Carriage in Two Cohorts of Mexican American Adults

Heather T. Essigmann, Craig L. Hanis, Stacia M. DeSantis, William B. Perkison, David A. Aguilar, Goo Jun, D. Ashley Robinson, Eric L. Brown

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Numerous host and environmental factors contribute to persistent and intermittent nasal Staphylococcus aureus carriage in humans. The effects of worsening glycemia on the odds of S. aureus intermittent and persistent nasal carriage was established in two cohorts from an adult Mexican American population living in Starr County, Texas. The anterior nares were sampled at two time points and the presence of S. aureus determined by laboratory culture and spa-typing. Persistent carriers were defined by the presence of S. aureus of the same spa-type at both time points, intermittent carriers were S. aureus-positive for 1 of 2 swabs, and noncarriers were negative for S. aureus at both time points. Diabetes status was obtained through personal interview and physical examination that included a blood draw for the determination of percent glycated hemoglobin A1c (%HbA1c), fasting plasma glucose, and other blood chemistry values. Using logistic regression and general estimating equations, the odds of persistent and intermittent nasal carriage compared to noncarriers across the glycemic spectrum was determined controlling for covariates. Increasing fasting plasma glucose and %HbA1c in the primary and replication cohort, respectively, were significantly associated with increasing odds of S. aureus intermittent, but not persistent nasal carriage. These data suggest that increasing dysglycemia is a risk factor for intermittent S. aureus nasal carriage potentially placing those with poorly controlled diabetes at an increased risk of acquiring an S. aureus infection. IMPORTANCE Factors affecting nasal S. aureus colonization have been studied primarily in the context of persistent carriage. In contrast, few studies have examined factors affecting intermittent nasal carriage with this pathogen. This study demonstrates that the odds of intermittent but not persistent nasal carriage of S. aureus significantly increases with worsening measures of dysglycemia. This is important in the context of poorly controlled diabetes since the risk of becoming colonized with one of the primary organisms associated with diabetic foot infections can lead to increased morbidity and mortality.

Original languageEnglish
JournalMicrobiology spectrum
Issue number3
StatePublished - Jun 2022

Bibliographical note

Funding Information:
Funding was received from National Institutes of Health grants R01DK116378 to E.L.B. and C.L.H. and grant 5T42OH008421 from NIOSH/Centers for Disease Control and Prevention to W.B.P.

Publisher Copyright:
Copyright © 2022 Essigmann et al. T


  • Staphylococcus aureus
  • diabetes
  • dysglycemia
  • intermittent carriage
  • nasal carriage
  • persistent carraige
  • spa typing

ASJC Scopus subject areas

  • Physiology
  • Ecology
  • Immunology and Microbiology (all)
  • Genetics
  • Microbiology (medical)
  • Cell Biology
  • Infectious Diseases


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