RESUMO
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 [spatype 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
RESUMO
Colonization with methicillin-resistant Staphylococcus aureus [MRSA] increases the risk for subsequent infections with an increased mortality and morbidity. Children were suggested to be a major asymptomatic reservoir for community-associated [CA] MRSA with an ability to quickly spread the MRSA within community. Therefore, the availability of epidemiological and antibiotic susceptibility data of CA-MRSA will be useful for the infection control and management policies. This study aimed to assess the nasal carriage, molecular characteristics and antibiotic susceptibility of MRSA in primary school-aged children from Jordan. A total of 210 nasal swabs were collected from children aged 6-11 years. Isolated MRSA and its SCCmec typing, Spa type and PVL [Panton-Valentine Leukociden] toxin were identified following culture, biochemical and PCR. Antibiogram was determined by the disc diffusion method. The prevalence of CA-MRSA was 7.1%. Allergic rhinitis and recent antibiotic exposure were the only significant risk factors for MRSA nasal carriage among children. Resistance to erythromycin, trimethoprim-sulfamethoxazole and tetracycline was 33.4, 20 and 13.4%, respectively. All isolates were susceptible to the remaining non-p-lactam antibiotics used in this study, in particular linezolid and mupirocin. All MRSA isolates were SCCmec type IV and PVL toxin negative and the majority were Spa type t223. This is the first study to assess the MRSA prevalence among children aged 6-11 years in Jordan. The prevalence in community children is within the range compared with other studies in other countries. The antibiogram, SCCmec and Spa types of the isolated MRSA are much similar to what was found previously in Jordan. However, all isolates were PVL toxin negative. The study recommends increasing the public awareness of MRSA and the proper antibiotics dispensing. Future studies to follow-up on the changing epidemiology of the CA-MRSA in Jordan are also recommended