Molecular analysis and susceptibility patterns of methicillin-resistant Staphylococcus aureus strains causing community- and health care-associated infections in the northern region of Palestine

• Published in: American journal of infection control Vol. 41; no. 3; pp. 195 - 198
• Main Authors: Adwan, Kamel, PhD, Jarrar, Naser, MS, Abu-Hijleh, Awni, PhD, Adwan, Ghaleb, PhD, Awwad, Elena, MS, Salameh, Yousef, BS
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-03-2013; Elsevier; Mosby-Year Book, Inc
• Subjects: Adult; Anti-Bacterial Agents - pharmacology; Antibiotics; Bacterial diseases; Biological and medical sciences; CA-MRSA; Chromosomes; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Cross Infection - epidemiology; Cross Infection - microbiology; Drug resistance; Epidemiology. Vaccinations; Female; General aspects; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; Infection Control; Infections; Infectious Disease; Infectious diseases; Male; Medical sciences; Methicillin-Resistant Staphylococcus aureus - drug effects; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Microbial Sensitivity Tests; Middle East - epidemiology; Molecular Typing; MRSA; Nasal carriage; Nasal Cavity - microbiology; Palestine; PCR assay; Phylogenic analysis; Prescription drugs; SCCmec typing; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus infections; Students; Universities; Young Adult; Asia; Palestine; Middle East; Palestine (pre-1948); PCR assay; Nasal carriage; SCC mec typing; MRSA; CA-MRSA; Phylogenic analysis; Palestine; SCCmec typing; Nosocomial infection; Drug susceptibility test; Check; Nasopharynx; Prevention; Microbiological investigation; Nose; Bacteria; Micrococcales; Micrococcaceae; Staphylococcus aureus; Typing; Infection; Polymerase chain reaction; Community acquired infection; Bacteriosis; Molecular biology; Staphylococcal infection; Colonization
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2012.03.040

Background Community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a major global problem. This study attempted to investigate the prevalence of nasal carriage of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) strains among 360 healthy university students at An-Najah National University, Palestine. For the purpose of comparing the staphylococcal cassette chromosome methicillin resistant determinant (SCC mec ) type of MRSA, 46 clinical MRSA isolates were also included in this study. Methods Susceptibility testing was performed by the disc diffusion method. The genetic association of MRSA isolates was investigated by SCC mec typing. A selected number of isolates were also used to amplify and sequence mecA. Results Nasal carriage of S aureus was found in 86 of 360 students (24%). MRSA accounted for 9% of S aureus isolates. All 86 strains of S aureus were sensitive to vancomycin. Resistance to penicillin G, amoxicillin/clavulanic acid, ciprofloxacin, erythromycin, and clindamycin was found in 98%, 93%, 33%, 23%, and 12% of the isolates, respectively. Resistance rates of the MRSA isolates were as follows: 100% resistant to penicillin G and amoxicillin/clavulanic acid, 96% to ethromycin, 52% to clindamycin, and 48% to ciprofloxacin. No vancomycin-resistant isolates were identified. In our study, nearly half (52%) of the MRSA isolates belonged to SCC mec types IVa and V. However, SCC mec types II and III are represented by 48%, whereas SCC mec type I was completely absent. Conclusion The findings of this study indicate the existence of SCC mec type IVa in both student nasal carriers and health care settings. This emphasizes the need for implementation of a revised set of control measures in both settings. Moreover, the rational prescription of appropriate antibiotics should also be considered.