Antibiotic resistances of S. aureus in refugee accommodations – an investigation from the microbiological perspective

Abstract

Abstract Background Antimicrobial resistance (AMR) has been added to the list of the “Ten threats to global health” of the WHO. Due to varying rates of AMR persistence in the different countries of the world, there is concern that migration might foster the burden of antibiotic resistance in Europe. As calculated before, prevalence of AMR is elevated in refugees. Refugees are supposed to have higher risk for AMR prevalence, constituted by the conditions in the European host countries and the countries of origin or transit. In European refugee accommodations poor sanitation, overcrowded living conditions and barriers accessing health care services are feasible risk factors. One example for AMR bacteria is the Methicillin-resistant Staphylococcus aureus (MRSA). In the last decades, S. aureus became a global threat for healthcare, through the gain of AMR genes. Methods Nasal swabs voluntarily provided by refugees living in accommodations in Bielefeld (Germany) were checked for presence of S. aureus. After identification by 16S rRNA sequencing the isolates were typified and antibiotic resistances were phenotypically detected by broth dilution method. For MRSA, the resistance genes were identified by PCR. Results Nasal swabs of participating refugees contain antibiotic resistant S. aureus, including MRSA. Some isolates are resistant against various therapeutic antibiotics, like clindamycin and erytromycin. Nearly all isolates are resistant against penicillins. Resistances against vancomycin and the reserve antibiotic linezolid were not detected. Conclusions Efforts to reduce AMR rates in Europe focus on surveillance, screening and antimicrobial stewardship. As the living situation in host countries is expected to be a risk factor for AMR persistence, host countries may also consider improving the accommodation of refugees.