Controversies in Hospital Infection Prevention: Staph: It's deeper than you think.
An antibody stain against S. aureus was applied to visualize the site of colonization. There were two important findings: (1) colonization only occurred distally in the stratified squamous epithelium (i.e., there was no colonization of the more proximal ciliated mucosa; and (2) in 6/9 cadavers, staph organisms were visualized in the hair follicle shaft, and in 2 the bacteria were visualized deep in the follicle. The presence of S. aureus deep in the hair follicle may explain why some patients do not decolonize or recolonize after decolonization with mupirocin since the drug may not be able to penetrate that deeply.
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