High incidence rate of methicillin-resistant Staphylococcus aureus (MRSA) among healthcare workers in Saudi Arabia

Abstract

Introduction: Nosocomial infections are normally hospital acquired. Nasal carriage of Staphylococcus aureus (S. aureus) is very common and may be transmitted via a hand-to-nose route. The objective of the present study was to screen healthcare workers for the colonization of their nasal cavities with MRSA. Methodology: The study group included hospital staff such as nurses, doctors, and technicians. The control group included university students. For isolation, nasal swabs were taken from the volunteers and cultured on mannitol salt agar media selective for S. aureus. Suspected colonies were confirmed by PCR using specific primers for the coagulase and mecA gene. Typing of the coagulase-positive strains was done using restriction fragment length polymorphism (RFLP). Results: The results indicated an incidence rate of 76% among healthcare workers. This is in comparison with students who served as control and were negative for MRSA. Using RFLP, four different types of MRSA were confirmed. Conclusions: The results of this study are alarming. Effective control measures must be formulated and implemented to avoid indiscriminate use of antimicrobials and the spread of these infectious agents in the region.

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

“…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]. Therefore, the MRSA frequencies described in this report may be considered among the highest described in the region thus far.…”

“…However, the nasal carriage rate in this study was higher than those found in other studies that conducted in Arabic countries and other developing countries as seen in a recent publications from Libya (12.4%) [38], India (17.5%) [39], West Bank of Palestine (20.8%) [16] and Kuwait (21%) [14]. Yet, other recent studies from Saudi Arabia (76%) [10], Taiwan (67.2%) [26] This article is available from: www.iajaa.org / www.medbrary.com and Senegal (56.1%) [25] showed nasal colonization among HCWs higher than our findings. A plausible explanation for the differences in the colonization rates of S. aureus and MRSA between different countries and even some time in the same country may be due in part to differences in sample size or frequency of sampling and using different conventional and/or molecular methods among others.…”

“…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].…”

“…aureus permanently colonizes the anterior nares of about 20% to 30% of the general population. Health care workers (HCWs) are more likely to be colonized than persons in the general population, presumably because of increased exposure, So, HCWs constitute an important reservoir of S. aureus and MRSA [9,10]. Nasal colonization with S. aureus in HCWs has been associated with an increased risk of invasive S. aureus infection [9,11].…”

Detection of methicillin resistant Staphylococcus areus isolated from nasal carriage of health care workers by polymerase chain reaction

“…These finding was contrary to that observed in the study done in Saudi Arabia which showed infection in the 'extremes of age' group (younger than one or older than 60 years) (Madani, 2002). Another study by Iyer et al (2014) from Jeddah found the double rates of MRSA colonization in age group of 40-50 years, which documented that MRSA infection, occur at a higher incidence in older people owing to a weaker immune system.…”