Prevalence of Methicillin-Resistant Staphylococcus aureus and Classical Enterotoxin Genes Among Sudanese Food Handlers.

Omar B Ahmed

doi:10.7759/cureus.12289

Abstract

Food handlers who carry enterotoxin-producing Staphylococcus aureus could become potential reservoirs of Staphylococcal food poisoning. The study is a cross-sectional one aimed to determine the prevalence of methicillin-resistant S. aureus (MRSA) and staphylococcal enterotoxins from randomly selected food handlers in Al Jazirah state, Sudan. Culture swabs were collected from the hands and nasals of food handlers (2016-2018). Identification of S. aureus was done on the basis of conventional laboratory tests. All S. aureus isolates were screened for MRSA and staphylococcal enterotoxin (SE) genes by polymerase chain reaction. The S. aureus strains were isolated from 25% of the collected culture swabs of which 42% were confirmed as MRSA. The existence of one or more of enterotoxin genes was confirmed in 34.4% of the isolated S. aureus strains. The combined staphylococcal enterotoxin genes were found in 9.6% of the isolates. The SE genes among MRSA strains (61.5%) were found to be higher than methicillin-sensitive S. aureus strains (14.8%). The most frequent staphylococcal enterotoxin genes were SEA (19.4%) followed by the SEB (8.6%), SEC (4.3%), and SED (2.1%). The carriage rate of MRSA strains demonstrated a higher rate of staphylococcal enterotoxins genes than methicillin-sensitive S. aureus. There is an increasing prevalence of MRSA compared with the previous rates and staphylococcal enterotoxin genes among Sudanese food handlers, which is a serious problem for public health.

Highlights

Foodborne diseases (FBDs), which involve a wide spectrum of illnesses caused by either microbial or chemical contamination of food, have become a global health problem
The Methicillinresistant S. aureus (MRSA) strains in the present study demonstrated a higher prevalence (61.5%) of staphylococcal enterotoxin (SE) genes which is significantly higher than methicillin-sensitive S. aureus (MSSA) (14.8%) (P < 0.05)
The present study showed that a combination of more than one enterotoxin gene was found in 9.6% of S. aureus isolates

Summary

Introduction

Foodborne diseases (FBDs), which involve a wide spectrum of illnesses caused by either microbial (bacteria, viruses, or parasitic) or chemical contamination of food, have become a global health problem. In Sudan, a large number of consumers suffer from FBDs, some become ill, and some die from them. The increase in FBDs in Sudan requires a rapid and effective response. Staphylococcal food poisoning (SFP) is a common FBD which is known as an intoxication due to exposure to staphylococcal enterotoxins (SEs) [3]. Food handlers may carry enterotoxin-producing S. aureus in their hands and secretions, they could become a potential source of SFP through direct contact or respiratory secretions. This study aimed to determine the prevalence of MRSA and SEs among S. aureus isolated from food handlers in Al Jazirah state, Sudan

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