Abstract
Background: Healthcare workers (HCWs) and medical students can be asymptomatic carriers in transmitting methicillin resistant and susceptible Staphylococcus aureus (MRSA and MSSA). Studying epidemiological and antibiotic susceptibility data is necessary to limit the spread of infections, help with treatment and understand the transmission dynamics of MSSA and MRSA. Our study assessed the rate of MSSA and MRSA nasal carriage and its antibiogram among medical students in basic and clinical years at the University of Jordan. Methods: A total of 210 nasal swabs were randomly collected from participants. MSSA and MRSA were identified by culture, biochemical and other phenotypical analysis methods. Antibiotic susceptibility was determined by the disc diffusion method. Results: The nasal carriage of MSSA was 6.6% and 11.4% and that of MRSA was 1.9% and 2.8% among basic and clinical years, respectively. There was no significant difference for the nasal carriage of MSSA and MRSA among basic and clinical year students (p value ≥ 0.05). MSSA resistance ranged between 25% and 33% for trimethoprim-sulfamethoxazole, tetracycline and ciprofloxacin. For MRSA, the highest resistance was to trimethoprim-sulfamethoxazole and tetracycline (67% to 100%), followed by gentamicin and ciprofloxacin (33% to 67%), in all participants in the study. Conclusion: The difference in the carriage rates of MSSA and MRSA among basic and clinical students was statistically insignificant. The continuous awareness and implementation of infection control procedures and guided patient contact are recommended. The results might also suggest that healthcare workers could be victims in the cycle of MRSA nasal carriage, a theory that needs further study.
Highlights
Staphylococcus aureus (S. aureus) is considered one of the most common commensal bacteria that is usually found in the anterior nares of healthy individuals, but it is a major pathogen that has been associated with serious community and nosocomial acquired infections, such as skin and soft tissue infections, pneumonia and bloodstream infections, which are associated with increased hospital mortality and morbidity [1,2]
Soon after the introduction of methicillin, resistance emerged in certain strains of S. aureus, and these strains became famously described as methicillin resistant Staphylococcus aureus (MRSA), which was first isolated in the UK in the early 1960s [3]
The aim of this study was to assess the carriage rates of methicillin susceptible Staphylococcus aureus (MSSA) and MRSA among medical students, from the basic first three years of medical study, who had not been not exposed to hospital practices, and compare the results to those of students in their last three clinical years of study and to assess the antibiotic susceptibility patterns of the isolated bacteria
Summary
Staphylococcus aureus (S. aureus) is considered one of the most common commensal bacteria that is usually found in the anterior nares of healthy individuals, but it is a major pathogen that has been associated with serious community and nosocomial acquired infections, such as skin and soft tissue infections, pneumonia and bloodstream infections, which are associated with increased hospital mortality and morbidity [1,2]. MRSA usually shows resistance to a wide range of other commonly prescribed anti-staphylococcal antibiotics, which limits therapeutic options, making it necessary to use specialized antibiotics such as glycopeptides and linezolid to treat MRSA associated infections [6]. This emerging resistance has led to increased mortality and morbidity rates, length of hospital stays and costs of treatment [2]. Healthcare workers (HCWs) and medical students can be asymptomatic carriers in transmitting methicillin resistant and susceptible Staphylococcus aureus (MRSA and MSSA). Results: The nasal carriage of MSSA was 6.6% and 11.4% and that of MRSA was
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