{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T06:06:33Z","timestamp":1791093993044,"version":"4.1.0"},"reference-count":23,"publisher":"BMJ","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1991,8]]},"abstract":"<jats:p>Following two outbreaks of staphylococcal scalded skin syndrome in a maternity unit, 500 pregnant women attending an antenatal clinic were screened for carriage of epidermolytic toxin producing Staphylococcus aureus. Nasal, axillary, and perineal swabs were collected from women whose gestational ages ranged from 12-40 weeks. Isolates of S aureus were purified, phage typed, and tested for methicillin sensitivity and production of epidermolytic toxin. The results showed that 164 (33%) women carried S aureus; of these, 100 (61%) were from the nose and three (2%) from axillae, but 41 (25%) strains were isolated from the perineum alone. Screening for nasal carriage alone will therefore miss 25% of carriers. More than one strain of S aureus was identified in seven of 20 women with multiple site carriage. Three (2%) methicillin resistant strains were isolated during the survey, and five (3%) isolates produced epidermolytic toxin. Phage typing identified 63 (34%) strains as non-typable, but 50% of isolates typed either groups I, II or III, and a further 10% represented varying combinations of these and other phage groups. These results provide baseline information on S aureus in the community, and identification of methicillin resistant and toxin producing strains shows a reservoir of outbreak potential which could become relevant on hospital admission of such a carrier.<\/jats:p>","DOI":"10.1136\/jcp.44.8.681","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"681-684","source":"Crossref","is-referenced-by-count":77,"title":["Nasal, axillary, and perineal carriage of Staphylococcus aureus among women: identification of strains producing epidermolytic toxin."],"prefix":"10.1136","volume":"44","author":[{"given":"S J","family":"Dancer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W C","family":"Noble","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1991,8,1]]},"reference":[{"key":"ref_1","first-page":"152","article-title":"Microbiology of human skin","author":"Noble, W.C.","year":"1981","unstructured":"Noble WC. Microbiology of human skin. London: Lloyd Luke, 1981:152-81."},{"key":"ref_2","first-page":"299","article-title":"Effect of age, sex, length of stay and antibiotic use on the nasal carriage of tetracycline resistant Staphylococcus aureus and on postoperative wound infection","volume":"79","year":"1977","unstructured":"Effect of age, sex, length of stay and antibiotic use on the nasal carriage of tetracycline resistant Staphylococcus aureus and on postoperative wound infection. JHyg Camb 1977;79:299-314.","journal-title":"JHyg Camb"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"791","DOI":"10.2105\/AJPH.50.6_Pt_1.791","article-title":"Studies on the incidence of coagulase-positive staphylococci in a normal unconfined population","volume":"50","author":"Millian, S.J.; Baldwin, J.N.; Rheins, M.S.; Weiser, H.H.","year":"1960","unstructured":"Millian SJ,Baldwin JN, Rheins MS, Weiser HH. Studies on the incidence of coagulase-positive staphylococci in a normal unconfined population. Am J Public Health 1960; 50:791-8.","journal-title":"Am J Public Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/jac\/18.Supplement_A.1","article-title":"The carrier state: methicillinresistant Staphylococcus aureus","volume":"A):","author":"Casewell, M.W.; Hill, R.L.R.","year":"1986","unstructured":"Casewell MW, Hill RLR. The carrier state: methicillinresistant Staphylococcus aureus. J Antimicrob Chemother 1986;18(Suppl A):1-12.","journal-title":"J Antimicrob Chemother"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1136\/bmj.1.5062.69","article-title":"Further studies on the transmission of Staphylococcus aureus","volume":"i:","author":"Hare, R.; Ridley, M.","year":"1958","unstructured":"Hare R, Ridley M. Further studies on the transmission of Staphylococcus aureus. Br Med J 1958;i:69-73.","journal-title":"Br Med J"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1017\/S0022172400024505","article-title":"Airborne infection in a fully air-conditioned hospital. IV Airborne dispersal of Staphylococcus aureus and its acquisition by patients","volume":"75","author":"Lidwell, O.M.; Brock, B.; Shooter, R.A.; Cooke, E.M.; Thomas, G.E.","year":"1975","unstructured":"Lidwell OM, Brock B, Shooter RA, Cooke EM, Thomas GE. Airborne infection in a fully air-conditioned hospital. IV Airborne dispersal of Staphylococcus aureus and its acquisition by patients. J Hyg Comb 1975;75:445-74.","journal-title":"J Hyg Comb"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1136\/jcp.17.1.79","article-title":"Some aspects of the nasal carriage of staphylococci","volume":"17","author":"Noble, W.C.; Williams, R.E.O.; Jevons, M.P.; Shooter, R.A.","year":"1964","unstructured":"Noble WC, Williams REO, Jevons MP, Shooter RA. Some aspects of the nasal carriage of staphylococci. J Clin Pathol 1964;17:79-83.","journal-title":"J Clin Pathol"},{"key":"ref_8","first-page":"44","article-title":"Hospital Infection","author":"Williams, R.E.O.; Blowers, R.; Garrod, L.P.; Shooter, R.A.","year":"1960","unstructured":"Williams REO, Blowers R, Garrod LP, Shooter RA. Hospital Infection. London: Lloyd Luke, 1960:44-62."},{"key":"ref_9","first-page":"165","article-title":"Staphylococcal skin infection in man","volume-title":"staphylococcal infections","author":"Noble, W.C.; White, M.I.","year":"1983","unstructured":"Noble WC, White MI. Staphylococcal skin infection in man. In: Easmon CSF, Adam C, eds. Staphylococci and staphylococcal infections. London: Academic Press, 1983: 165-91."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1017\/S0022172400000966","article-title":"Impetigo contagiosa: the association of certain types of Staphylococcus aureus and of Streptococcus pyogenes with superficial skin lesions","volume":"53","author":"Parker, M.T.; Tomlinson, A.J.H.; Williams, R.E.O.","year":"1955","unstructured":"Parker MT, Tomlinson AJH, Williams REO. Impetigo contagiosa: the association of certain types of Staphylococcus aureus and of Streptococcus pyogenes with superficial skin lesions. J Hyg Camb 1955;53:458-73.","journal-title":"J Hyg Camb"},{"key":"ref_11","first-page":"1114","article-title":"The staphylococcal scalded skin EsnygnldJromMee.d Development of","volume":"282","author":"Melish, M.E.; Glasgow, L.A.","year":"1970","unstructured":"Melish ME, Glasgow LA. The staphylococcal scalded skin EsnygnldJromMee.d Development of 1970;282:1114-9."},{"key":"ref_12","first-page":"483","article-title":"Braun-Falco 0. The staphylococcal scalded skin syndrome. An experimental histodermatological and electron microscopic study","volume":"96","author":"Dimond, R.L.; Wolff, H.H.","year":"1977","unstructured":"Dimond RL, Wolff HH, Braun-Falco 0. The staphylococcal scalded skin syndrome. An experimental histodermatological and electron microscopic study. Br J Dermatol 1977;96:483-92.","journal-title":"Br J Dermatol"},{"key":"ref_13","first-page":"267","article-title":"Staphylococcus aureus: some host-parasite interactions","volume":"236","author":"Kapral, F.A.","year":"1974","unstructured":"Kapral FA. Staphylococcus aureus: some host-parasite interactions. Ann NY Acad Sci Galinsky J. Exfoliatin production 1974;236:267-76.","journal-title":"Acad Sci Galinsky J. Exfoliatin production"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1099\/00222615-14-3-341","article-title":"Prevalence of epidermolytic toxin in clinical isolates of Staphylococcus aureus","volume":"14","author":"de Azevado J; JP, Arbuthnott","year":"1981","unstructured":"de Azevado J, Arbuthnott JP. Prevalence of epidermolytic toxin in clinical isolates of Staphylococcus aureus. J Med Microbiol 1981;14:341-4.","journal-title":"J Med Microbiol"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/occmed\/16.1.18","article-title":"The bacteriological flora of the skin and its relation to post-operative wound infection","volume":"16","author":"Black, T.","year":"1966","unstructured":"Black T. The bacteriological flora of the skin and its relation to post-operative wound infection. Trans Soc Occup Hyg 1966;16: 18-23.","journal-title":"Trans Soc Occup Hyg"},{"key":"ref_16","first-page":"567","article-title":"Carriage of PolpSaotkpaoupflhSfa, ytlioocnRo. JiccchuaHsrydgasuCrIeaDumGsb, in random samples of a normal","volume":"65","author":"Noble, W.C.; Valkenburg, H.A.; Wolters, C.H.L.","year":"1967","unstructured":"Noble WC, Valkenburg HA, Wolters CHL. Carriage of PolpSaotkpaoupflhSfa,ytlioocnRo.JiccchuaHsrydgasuCrIeaDumGsb, in random samples of a normal 1967;65:567-73."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1136\/jcp.22.3.249","article-title":"Skin carriage of the Micrococcaceae","volume":"22","author":"Noble, W.C.","year":"1969","unstructured":"Noble WC. Skin carriage of the Micrococcaceae.J Clin Pathol 1969;22:249-53.","journal-title":"J Clin Pathol"},{"issue":"178","key":"ref_18","first-page":"1","article-title":"A studyof carriers of Staphylococcus aureus","volume":"1965","author":"Solberg, C.O.","unstructured":"Solberg CO. A studyof carriers of Staphylococcus aureus. Acta Med Scand 1965;(Suppl)178: 1-96.","journal-title":"Acta Med Scand"},{"key":"ref_19","first-page":"327","article-title":"Bacterial interference TinscthhaernceonrtCr, olHaolfliewxeuldlatRiEveW, epeiddse.rmAidtviasncoefspiignsv.etIenr:invaorny dermatology","author":"Allaker, R.P.; Lloyd, D.H.; Al, Lamport","year":"1990","unstructured":"Allaker RP, Lloyd DH, Lamport Al. Bacterial interference TinscthhaernceonrtCr,olHaolfliewxeuldlatRiEveW,epeiddse.rmAidtviasncoefspiignsv.etIenr:invaorny dermatology. London: Bailliere Tindall, 1990:327-34."},{"key":"ref_20","first-page":"399","article-title":"The staphylococcus outside hospital. I The occurrence of staphylococcal phage types in the extra-hospital environment. Z Bakt Parasitol Infekt Hyg I Abt Orig","volume":"156","author":"Ramamurti, D.V.; Kanz, E.","year":"1972","unstructured":"Ramamurti DV, Kanz E. The staphylococcus outside hospital. I The occurrence of staphylococcal phage types in the extra-hospital environment. Z Bakt Parasitol Infekt Hyg I Abt Orig 1972;156:399-405."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1128\/JCM.23.1.83-91.1986","article-title":"Importance of epidermolytic toxin A production by Staphylococcus aureus strains isolated from clustered epidemics of neonatal pustulosis","volume":"23","author":"Kaplan, M.H.; Chmel, H.; Hsieh, H.-C.; Stephens, A.; Brinkso, V.","year":"1986","unstructured":"Kaplan MH, Chmel H, Hsieh H-C, Stephens A, Brinkso V. Importance of epidermolytic toxin A production by Staphylococcus aureus strains isolated from clustered epidemics of neonatal pustulosis. J Clin Microbiol 1986; 23:83-91.","journal-title":"J Clin Microbiol"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1001\/archderm.1989.01670130087012","article-title":"Staphylococcal scalded skin syndrome mimicking acute graft versus host disease in a bone marrow transplant recipient","volume":"125","author":"Goldberg, N.S.; Ahmed, T.; Robinson, B.; Ascensao, J.; Horowitz, H.","year":"1989","unstructured":"Goldberg NS, Ahmed T,Robinson B, Ascensao J, Horowitz H. Staphylococcal scalded skin syndrome mimicking acute graft versus host disease in a bone marrow transplant recipient. Arch Dermatol 1989;125:85-7.","journal-title":"Arch Dermatol"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/0195-6701(84)90007-0","article-title":"Analysis of an outbreak of the staphylococcal scalded skin syndrome; strategies for typing non-typable staphylococci","volume":"5","author":"Dowsett, E.G.; Petts, D.N.; Baker, S.L.","year":"1984","unstructured":"Dowsett EG, Petts DN, Baker SL, et al. Analysis of an outbreak of the staphylococcal scalded skin syndrome; strategies for typing non-typable staphylococci. J Hosp Infect 1984;5:391-7.","journal-title":"J Hosp Infect"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.44.8.681","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T10:23:58Z","timestamp":1758795838000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.44.8.681"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1991,8]]},"references-count":23,"journal-issue":{"issue":"8","published-online":{"date-parts":[[1991,8,1]]},"published-print":{"date-parts":[[1991,8]]}},"alternative-id":["10.1136\/jcp.44.8.681"],"URL":"https:\/\/doi.org\/10.1136\/jcp.44.8.681","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[1991,8]]}}}