Abstract
The aim of this study was to determine the prevalence of nasal carriage of Staphylococcus aureus among patients and personnel of private centers at Casablanca, and to determine the resistance pattern of isolates. The carriage of virulence toxin genes by the methicillin resistant strains was also investigated. This study was conducted from November 2008 to February 2009. Nasal swabs were taken from 145 and 42 patients and personnel respectively. The susceptibility testing to 16 antibiotics was performed using the agar disc diffusion method. Minimum inhibitory concentrations (MICs) of oxacillin were determined by the agar dilution method for all strains demonstrating resistance to cefoxitin. In addition, resistant isolates were examined for the existence of the mecA gene by polymerase chain reaction (PCR). Furthermore, the carriage of 22 virulence toxin genes among strains showing resistance to cefoxitin was investigated by PCR Multiplex. The prevalence of nasal carriage of S. aureus was 32.4% (n=47) and 38.1% (n=16) in patients and personnel, respectively. Patients’ strains showed 16 resistance patterns against only 4 in personnel strains. No S. aureus isolates were found to be resistant to lincomycin, pristinamycin, gentamicin, chloramphenicol, trimethoprim-sulfamethoxazole, rifampicin and vancomycin, while over 90% (n = 59) were resistant to penicillin G. For the other antibiotics, the percentage of resistance varied between 2.63 and 18.75%. One S. aureus (1.6%) was methicillin resistant by possession of mecA gene. This isolate harboured the staphylococcal enterotoxin genes sec, sed, sell, selm, selo, ser and toxic shock syndrome toxin gene (tst). Investigation of S. aureus nasal carriage and characterization of isolates among patients undergoing hemodialysis is important to develop infection prevention and to limit the spread of methicillin resistant S. aureus (MRSA) strains. Key words: Hemodialysis centers, patients, personnel, Staphylococcus aureus, nasal carriage, antibiotic susceptibility, methicillin resistance, toxin genes.
Highlights
The anterior are the primary reservoir of Staphylococcus aureus in humans and its nasal carriage is recognised as a major risk factor for the development of both community-acquired and nosocomial infections (Boelaert et al, 1995; Koziol-Montewka et al, 2001), in patients who are undergoing long-term hemodialysis376 Afr
We investigated a total of 42 personnel members (20 men (47.6%) and 22 women (52.4%)) and 145 patients (73 men (50.3%) and 72 women (49.7%)), who were between 15 and 94 years of age
We revealed that 32.4 and 38.1% of hemodialyzed patients and personnel respectively, were S. aureus carriers
Summary
The anterior are the primary reservoir of Staphylococcus aureus in humans and its nasal carriage is recognised as a major risk factor for the development of both community-acquired and nosocomial infections (Boelaert et al, 1995; Koziol-Montewka et al, 2001), in patients who are undergoing long-term hemodialysis. (Watanakunakorn et al, 1992). Infections complications are the main cause of morbidity and the second cause of mortality after cardiovascular diseases in chronic hemodialyzed patients. S. aureus is by far the most frequent bacterium implicated in these infections, especially in septicemia (Forestier et al, 2007; Koziol-Montewka et al, 2001; Koziol-Montewka et al, 2006)
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