Molecular epidemiology of nasal isolates of methicillin-resistant Staphylococcus aureus from Jordan

Abstract

Asymptomatic carriage of methicillin-resistant Staphylococcus aureus (MRSA) can predispose the host to a wide range of infections. To inform public health strategies, this study sought to determine the prevalence and the phenotypic and genotypic characteristics of MRSA from nasal swabs of health care workers (HCWs) and other healthy individuals in Jordan. Overall, 716 nasal swabs were collected from 297 HCWs, 141 adults and 278 children in the community. MRSA was recovered from 56 (7.8%) nasal swabs, which represented carriage rates of 10.1%, 4.3% and 7.2% among HCWs, adults and children, respectively. The MRSA isolates were resistant to oxacillin (100%), erythromycin (42.8%), tetracycline (37.5%), clindamycin (5.3%), fucidin (5.3%), and ciprofloxacin (3.5%). A total of 17 different spa types belonging to eight different clonal complexes (CCs) were identified. All isolates were mecA positive, and mecC-MRSA was not detected. Analysis of the staphylococcal cassette chromosome mec (SCCmec) elements revealed that the majority (54; 96.4%) of the samples harbored the smaller type IV and V elements (the most common were SCCmec IVa or IVc, and there were two each of the IVg and V elements), and two were nontypable. The genes for Panton-Valentine leukocidin (luk-PV) were detected in 5.4% of the study isolates. A tst-positive, CC22-MRSA-SCCmecIVa clone (spa type t223) was identified as the dominant MRSA lineage among the nasal carriage isolates from both HCWs and other individuals (adults and children) in the community. These findings provide important information for public health personnel for the formulation of effective infection prevention and control strategies. Studies to further our understanding of the distribution, pathogenicity, transmissibility and fitness of this lineage would be prudent.

Detection and antibiotic resistance pattern of Staphylococcus aureusand (MRSA) isolated from healthcare workers Nares at three Gaza hospitals, Palestine

“…Almost all MRSA and MSSA were resistant to penicillin and ampicillin. This pattern of resistance was shown in previous studies from Gaza Strip and West Bank [16,28,29] and also mirrored others elsewhere [5,13,18,20,[22][23][24]. High resistance to tested antibiotics could be mainly due to the excessive use, misuse, and great prescription of these medication in Gaza for both hospital and community acquired infections and also in agriculture and animal feeding.…”

“…3). This finding contradict the results of a recent study from Jordan that showed MRSA isolates were susceptible to a broad range of tested antibiotics, and none were MDR [13]. Meanwhile, Kaibni et al, showed also less resistant to non-β-lactam antimicrobial agents but with 14.7% being MDR [16].…”

“…All other reports of MRSA prevalence in Palestine have involved nasal carriage among healthy personnel who have not contact with hospital environment or hospital-based studies [16,[28][29][30]41], although notably, 45% of the S. aureus isolates from the Gaza carriage study were methicillin-resistant [30]. Other studies from Arabic countries and worldwide showed lower prevalence of MRSA among HCWs as in Jordan (10.1%) [13], in USA (12%, 15.2%) [12,19], in Iran (17.2%) [20] and in Libya (36.8%) [22]. Interestingly, a higher prevalence (73%) of MRSA than our findings was detected among HCWs in a recent study conducted in Saudi Arabia [10].…”

“…First, HCWs may become infected by their own MRSA carriage strains; second, they could serve as a route of cross-transmission to patients; and finally, they may introduce the pathogen into their communities [12]. Several studies in Arabic countries and worldwide have reported that the rate of the nasal carriage of S. aureus and MRSA among HCWs ranges from 10.1%-76% [10,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The screening of nasal carriage in HCWs is an important component in the control of MRSA in any health care facility [27].…”

Using multiplex PCR as a diagnostic tool to detect methicillin resistant Staphylococcus aureus

“…In the study conducted by Aqel et al [14] on nasal swabs of health care workers in Jordan, the frequency as well as phenotypic/genotypic features of MRSA was investigated. They discovered MRSA in 56 (7.8%) nasal swabs, which were all resistant to oxacillin.…”