During the past few years there has been a dramatic increase in the rate of community associated infections caused by Staphylococcus aureus, particularly strains of methicillin-resistant S. aureus. This has been particularly problematic in recruits enrolled in US military training facilities. This training combines many of the suspected risk factors of S. aureus infections including crowded conditions, limited time for personal hygiene, and multiple skin abrasions. This study was designed to assess the incidence of infection in a well-defined population of marine recruits and the effectiveness of using chlorhexidine body cloths in preventing S. aureus colonization and infection in this population. All marine recruits willing to participate in this study provided nasal and axilla specimens for S. aureus culture. Specimens were collected at the time of initiation of training, once every two weeks thereafter, and at the completion of training. Specimens were transported immediately to the central testing facility at the NIH Clinical Center Microbiology Laboratory where specimens were inoculated into selective broth media to maximize recovery of the organisms. Organisms were identified by traditional phenotypic tests and antimicrobial susceptibility tests were performed by broth microdilution. All isolates were frozen at -80C for later testing as required (e.g., assessment of virulence factors). A total of three classes of recruits were cultured todate with 1214 recruits volunteering for the study (57% of the recruits). A total of 75% of the cultured recruits were colonized with S. aureus during the study period. At the present time, the effectiveness of the chlorhexidine body wash has not been assessed but the high incidence of S. aureus is consistent with the well-recognized problem of staphylococcal skin and soft tissue infections in this population. Further enrollment of recruits is anticipated during the next 6 month period.
