Staphylococcus aureus colonization and strategies for decolonization

Staphylococcus aureus is a leading cause of death by infectious diseases worldwide. Treatment of S. aureus infections is difficult due to widespread antibiotic resistance, calling for alternative approaches and infection prevention measures. Because S. aureus infections commonly arise from asymptomatic colonization, decolonization is considered a key approach for S. aureus infection prevention. Current decolonization procedures include antibiotic and antiseptic-based eradication of S. aureus from the nose and skin. However, despite widespread implementation and partial success of such measures, S. aureus infection rates are still high and resistance to decolonization agents is on the rise. This review will outline the epidemiology and mechanisms of S. aureus colonization, describe how colonization underlies infection, and discuss current and novel approaches for S. aureus decolonization with a focus on recent findings regarding probiotic strategies and the intestinal S. aureus colonization site.