Nasal carriage of Staphylococcus aureus among healthy adults

Department of Clinical Laboratory Sciences, Universiti Putra Malaysia, Selangor, Malaysia.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi (Impact Factor: 2.35). 01/2007; 39(6):458-64.
Source: PubMed


Data on the carriage rate and antibiotic sensitivity pattern of Staphylococcus aureus strains prevalent in the community are not available for many developing countries including Malaysia. To estimate the extent of community S. aureus transmission, in particular methicillin-resistant S. aureus (MRSA), the prevalence of S. aureus nasal colonization in a population of healthy adults was determined. Factors associated with S. aureus nasal carriage and antibiotic sensitivity patterns of the isolates were also analyzed.
A cross-sectional study involving 346 adults was conducted. Nasal swabs were examined for the presence of S. aureus. Epidemiological information concerning risk factors for nasal carriage was also obtained. Antibiotic susceptibility testing was performed using the disk diffusion method according to the National Committee for Clinical Laboratory Standards guidelines. MRSA strains isolated were further subjected to pulse-field gel electrophoresis analysis.
The prevalence of S. aureus nasal carriage was 23.4%. The findings also revealed that ex-smokers (95% confidence interval [CI] 1.08-6.32, p=0.033) and oral contraceptive users (95% CI 1.12-21.67, p=0.035) were more likely to harbor S. aureus. One person was colonized with MRSA, which was different from the hospital strain.
MRSA nasal colonization was found to be low outside of the health care environment. Smokers and oral contraceptive users have high nasal carrier rates.

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    • "Staphylococcal nasal carriers and particularly MRSA pose a major hazard in hospitals and contribute to the wider problem of hospital-acquired infection (Aldeyab et al. 2008). A marked increase in the prevalence of MRSA infections has been reported in Malaysia since the mid-1985 (Choi et al. 2006). All MRSA isolates encountered in this study were resistant to penicillin, oxacillin, ciprofloxacin , gentamicin and erythromycin. "
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    ABSTRACT: Background: Staphylococcus aureus is a frequent cause of hospital and community-acquired infections globally. Antimicrobial resistance able to provide results within 24 h and suitable for use in the diagnostic laboratory. The aim of the present study was to show a representative picture of antibiotic susceptibility patterns of S. aureus strains from a tertiary hospital in Kelantan, Malaysia. Methods: Antimicrobial resistance patterns were determined in 124 methicillin-sensitive Staphylococcus aureus and 34 methicillin- resistant Staphylococcus aureus strains isolated from blood (5.7%), cerebrospinal fluid (0.5%), respiratory tract (11.8%), eye (1.6), pus and wound (73.3%), urine (1.8%), genital specimens (1.0%), environment (3.3%) and other sites (1.0%). Results: All methicillin-resistant Staphylococcus aureus isolates were entirely resistant to penicillin, oxacillin, ciprofloxacin, erythromycin, and gentamicin; and were fully sensitive to tigecyclin, linezolid, vancomycin, and teicoplanin. The susceptibility of methicillin-resistant strains to trimethoprim-sulphamethazole, and rifampin was low, while clindamycin, fusidic acid, mupirocin, and chloramphenicol remained active. The susceptibility of methicillin-sensitive strains to penicillin was 6.5%, clindamycin 96.8%, oxacillin 100%, tigecyclin100%, erythromycin 98.4%, chloramphenicol 100%, mupirocin 100%, ciprofloxacin 82.3%, linezolid 100%, gentamicin 90.3%, trimethoprim-sulphamethazole 95.1%, fusidic acid 83.9%, rifampin 100%, vancomycin 100%, and teicoplanin100%. One MRSA isolate showed low-level resistance to mupirocin (MIC: 128 mg/L). Conclusions: These data are useful in improving background data on antimicrobial resistance of S. aureus in nosocomial infections, supporting the prudent use of antibiotics, and improving the infectious diseases control programs.
    International Medical Journal (1994) 04/2015; 22(1):1-3. · 0.09 Impact Factor
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    • "The prevalence of antimicrobial resistance was generally low with the only exception of penicillin resistance, which is widespread in human isolates of S. aureus worldwide [15], [32], [33]. One exception to this general rule is provided by a remote community of Pigmies in Gabon, where high susceptibility to penicillin (>60%) has recently been reported, probably as a consequence of a limited usage of antimicrobial agents in this population [16]. "
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    ABSTRACT: The epidemiology of Staphylococcus aureus in the community in Ghana was never investigated prior to this study. The aims of the study were: i) to assess prevalence of nasal S. aureus carriage in Ghanaian people living in an urban and a rural area, and ii) to identify phenotypic and genotypic traits of strains isolated from the two communities. Nasal swabs were collected from healthy individuals living in an urban community situated in the suburb of the capital city, Accra (n = 353) and in a rural community situated in the Dangme-West district (n = 234). The overall prevalence of nasal carriage was 21% with a significantly higher prevalence in the urban (28%) than in the rural community (11%) (p<0.0001). The levels of antimicrobial resistance were generally low (<5%) except for penicillin (91%) and tetracycline (25%). The only two (0.3%) MRSA carriers were individuals living in the urban area and had been exposed to hospitals within the last 12 months prior to sampling. Resistance to tetracycline (p = 0.0009) and presence of Panton-Valentine leukocidin (PVL) gene (p = 0.02) were significantly higher among isolates from the rural community compared to isolates from the urban community. Eleven MLST clonal complexes (CC) were detected based on spa typing of the 124 S. aureus isolates from the two communities: CC8 (n = 36), CC152 (n = 21), CC45 (n = 21), CC15 (n = 18), CC121 (n = 6), CC97 (n = 6), CC30 (n = 5), CC5 (n = 5), CC508 (n = 4), CC9 (n = 1), and CC707 (n = 1). CC8 and CC45 were less frequent in the rural area than in the urban area (p = 0.02). These results reveal remarkable differences regarding carriage prevalence, tetracycline resistance, PVL content and clonal distribution of S. aureus in the two study populations. Future research may be required to establish whether such differences in nasal S. aureus carriage are linked to socio-economic differences between urban and rural communities in this African country.
    PLoS ONE 04/2014; 9(4):e96119. DOI:10.1371/journal.pone.0096119 · 3.23 Impact Factor
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    • "A marked increase in the prevalence of MRSA infections has been reported in Malaysia since the mid-1985 (Choi et al., 2006). A wide range of MRSA nasal carriage rates have been observed (Choi et al., 2006; Askarian et al., 2009; Johnson et al., 2009), which could be attributed to different study populations, interpretation guidelines and culture techniques. Out of these 550 Staphylococcus species isolates, 312 were isolated from inpatients, 156 were from patients accompanied relatives, and 82 were from HCWs. "
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    ABSTRACT: Staphylococcus aureus nasal carriage is a common source of nosocomial infection and colonization. The aim of the present study was to assess the burden of methicillin-resistant S. aureus nasal carriage, its association with factors of interest including its genetic relationships. The prevalence of S. aureus nasal carriage was found to be 28.7%. This study showed that patients with a history of previous antibiotic intake, nasogastric tube, and longer hospitalization had a significantly high risk of being MRSA nasal carriers. The genetic relationship of all 34 nasal MRSA isolates revealed four major clusters of isolates, and there was a relationship between MRSA isolated from inpatients and healthcare workers.
    Polish journal of microbiology / Polskie Towarzystwo Mikrobiologów = The Polish Society of Microbiologists 07/2013; 62(1):109-12. · 0.70 Impact Factor
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