Prevalence Of Methicillin-resistant Staphylococcus Aureus Research Articles

Prevalence of resistance and toxin genes in community-acquired and hospital-acquired methicillin-resistant Staphylococcus aureus clinical isolates.

Objective(s):Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major health hazards and became of greater public health concern since the emergence of community-acquired MRSA. This work aimed to study the prevalence of mecA, femA, femB, lukS-PV, lukF-PV (PVL), intI, and intII genes among community-acquired (CA) hospital-acquired (HA) MRSA to increase vigilance in the diagnosis and management of suspected infections. Materials and Methods: S. aureus isolates recovered from clinical samples were classified into community or hospital-acquired and tested for their antibiotic susceptibility against 19 antibiotics. All isolates were screened for mecA, femA, femB, lukS-PV, lukF-PV, intI, and intII genes. Statistical correlations were carried out.Results:Out of 338 S. aureus isolates, only 105 were MRSA and classified as 77 CA-MRSA and 28 HA-MRSA. mecA and femA genes were present in all HA-MRSA and CA-MRSA isolates. femB was found in all HA-MRSA and 93.5% of CA-MRSA isolates. PVL genes were detected in 28.6% HA-MRSA isolates and 92.2% CA-MRSA. intI gene was recovered from 60.7% HA-MRSA isolates and 37.7% CA-MRSA isolates while the intII gene recovered from only 10.7% HA-MRSA isolates and 6.5% CA-MRSA.Conclusion:The high prevalence of MRSA colonizing the groin, axilla, and nose may play a significant role in endogenous infection, re-infection, and also acts as a route for MRSA transmission. mecA and femA genes could be used as a sole and fast step for identification of MRSA, while PVL genes cannot be used as a sole stable marker for CA-MRSA identification.

Occurrence of mecA and blaZ genes in methicillin-resistant Staphylococcus aureus associated with vaginitis among pregnant women in Ado-Ekiti, Nigeria.

Methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly prevalent pathogen. We studied the prevalence of MRSA and its association with vaginitis during pregnancy. Bacteriological investigations of high vaginal swabs of 350 healthy pregnant women attending antenatal clinics were carried out. Staphylococci were isolated from high vaginal swabs of 135 of the women. The staphylococcal isolates were resistant to multiple antibiotics. The PCR amplification of DNA of 20 selected isolates yielded six possessing the mecA gene and 13 the blaZ gene. MRSA possessing both the mecA and blaZ genes were isolated from subjects who reported vaginal discharge and itching.

Reduction in Methicillin-Resistant Staphylococcus aureus (MRSA) Surveillance in a Low-Prevalence Neonatal Intensive Care Unit Does Not Lead to Increase in Vancomycin Utilization

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infection in neonates is associated with significant morbidity, mortality, and hospital cost. Multiple studies have shown that these infections are often preceded by colonization, but no consensus has been established for MRSA surveillance. The impact of changing the surveillance strategy on vancomycin utilization has not been evaluated previously. Methods: Retrospective chart review of infants who underwent MRSA screening in a level IV NICU with all outborn neonates. A weekly surveillance PCR was obtained from the nares between July 2016 and June 2017 (phase 1) and only on admission and discharge between July 2017 and June 2018 (phase 2). Patients with a positive PCR were placed on contact precautions without decolonization. The χ2 test was performed to compare the 2 phases of screening, and the Student t test and the Fisher exact test were used to compare the characteristics of MRSA colonized infants. Vancomycin utilization was measured in days of therapy (DOT) per 1,000 NICU patient days. Results: In total, 689 infants underwent MRSA screening during the study period; 324 infants had weekly MRSA surveillance and 365 infants had screening at admission and discharge. There was no statistically significant difference in MRSA colonization rates (4.3% vs 3.0%) or MRSA colonization acquisition (negative to positive, 1.8% vs 1.0%) between the phases. Among MRSA-colonized patients, nearly 60% were colonized on admission. Nearly 40% of the infants became colonized with MRSA during their hospitalization, none of whom developed MRSA infections prior to discharge. Mean vancomycin utilization decreased from 38.55 to 30.16 DOT per 1,000 NICU patient days between the 2 study periods. Conclusions: In a level IV NICU with relatively low MRSA prevalence, the change in MRSA screening practice from weekly surveillance to surveillance upon admission and discharge demonstrated no difference in MRSA acquisition or infection. Overall vancomycin utilization also decreased during this period, suggesting a culture shift around antibiotic utilization. Further study is needed to evaluate the utility of MRSA screening, decolonization, and isolation practices in low-prevalence NICUs and to identify additional drivers of vancomycin utilization.Funding: NoneDisclosures: None

Acquisition Risk Factors of the SCCmec IX-Methicillin-Resistant Staphylococcus aureus in Swine Production Personnel in Chiang Mai and Lamphun Provinces, Thailand.

Methicillin-resistant Staphylococcus aureus (MRSA) harboring the type-IX staphylococcal cassette chromosome mec (SCCmec) has been found in pigs and humans in Northern Thailand. However, knowledge of the prevalence and acquisition risk factors of this MRSA strain among swine production personnel (SPP) are needed. The nasal swab samples and data were collected from 202 voluntary SPP and 31 swine farms in Chiang Mai and Lamphun Provinces, Thailand in 2017. MRSA were screened and identified using mannitol salt agar, biochemical and antimicrobial susceptibility testing, multiplex PCR, and the SCCmec typing. The prevalence of MRSA was 7.9% (16/202) and 19.3% (6/31) among SPP and swine farms. All isolates were multidrug-resistant, and 55 of 59 isolates (93%) contained the type-IX SCCmec element. Data analysis indicated that education, working time, contact frequency, working solely with swine production, and personal hygiene were significantly related to MRSA acquisition (p < 0.05). The multivariate analysis revealed that pig farming experience, working days, and showering were good predictors for MRSA carriage among SPP (area under the curve (AUC) = 0.84). The biosecurity protocols and tetracycline use were significantly associated with MRSA detection in pig farms (p < 0.05). Hence, the active surveillance of MRSA and further development of local/national intervention for MRSA control are essential.

Methicillin-Resistant Staphylococcus aureus (MRSA) in Slaughter Houses and Meat Shops in Capital Territory of Pakistan During 2018-2019.

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) is a major concern in many parts of the world, including Pakistan. The aim of this study was to investigate the prevalence of MRSA in slaughterhouses and meat shops in Rawalpindi-Islamabad, Pakistan, 2018–2019. A total of 300 samples were collected: 40 from each of working area, tools (knives, hooks), butcher hands and beef, 30 from each of chicken and mutton, 20 from each of nasal and rectal swabs. S. aureus was phenotypically identified by performing gram staining and biochemical tests. 150 of the 300 samples were confirmed to be S. aureus by phenotypic identification. MRSA was identified among S. aureus positive isolates by performing disk diffusion test and by detecting S. aureus-specific genes such as 16s rRNA, nuc, mecA, spa, and coa. Out of 150 isolates 96 (63%) showed resistance to antibiotic cefoxitin, known as a potential marker for detecting MRSA. While all 150 isolates have shown complete resistance to the four antibiotics neomycin, methicillin, ciprofloxacin and tetracycline. The nuc and 16s rRNA genes were detected in all 150 S. aureus-positive isolates and 118 (79%) were confirmed to be MRSA through the detection of the mecA gene. MRSA prevalence was highest in chicken (23/30, 77%) followed by beef (25/40, 63%), mutton (15/30, 50%), knives (18/40, 45%), nasal swabs (7/20, 35%), working area (11/40, 28%), rectal swabs (5/20, 25%), hooks (7/40, 18%), and butcher hands (7/40, 18%). 50 MRSA-positive isolates were chosen to identify two virulence factors (spa and coa gene). Of the 50 MRSA isolates subject to coa and spa gene typing, 27 (54%) were positive for the coa gene and 18 (36%) were positive for the spa gene, respectively. To the best of our knowledge, this was the first study on the molecular identification of MRSA in meat samples from Pakistan. High prevalence of MRSA in meat samples demand for implementation of proper hygienic practices and procedures during the slaughtering, transport and marketing of meat and meat products in order to prevent the spread of these bacteria to the human population.

Methicillin-resistant Staphylococcus aureus in the Americas: systematic review and metanalysis of prevalence in food-producing animalsStaphylococcus aureus resistente a la meticilina en la Región de las Américas: revisión sistemática y metanálisis de la prevalencia en la actividad agropecuaria

RESUMOObjetivo.Determinar a prevalência de Staphylococcus aureus resistente à meticilina (MRSA) em animais destinados à produção de alimentos na região das Américas.Métodos.Foi realizada uma revisão sistemática nas seguintes bases de dados: Scopus, Web of Science, MEDLINE, EMBASE e Biblioteca Virtual de Saúde (BVS). Foram selecionados artigos publicados nos últimos 10 anos, sem restrição quanto ao idioma. O desfecho de interesse foi a prevalência de MRSA em animais destinados à produção de alimentos. As prevalências foram agrupadas em metanálises de efeitos aleatórios pelo método de DerSimonian e Laird. A distribuição geográfica dos microrganismos resistentes e o decurso temporal das tendências de resistência também foram analisados.Resultados.Dos 19 estudos incluídos, 11 foram conduzidos nos Estados Unidos e 11 analisaram amostras em suínos. Cinco estudos foram realizados na América do Sul. As amostras analisadas foram coletadas em locais de criação, de abate e de venda. A prevalência de MRSA na região das Américas foi de 7,6% (IC95%: 5,6 a 9,5%) e apresentou-se maior em suínos [12,6% (IC95%: 7,0 a 18,2%)], seguidos por bovinos [2,4% (IC95%: 1,2 a 3,7%)] e aves [1,8% (IC95%: 0,3 a 3,4%)]. Observou-se maior prevalência de MRSA na população de suínos da América do Norte e de bovinos da América Latina. Não houve variação significativa da prevalência de resistência nos 10 anos analisados.Conclusões.A prevalência de MRSA em animais destinados à produção de alimentos na região das Américas foi maior em suínos, sem variação significativa da prevalência no decurso temporal.

Antimicrobial Resistance Pattern of Methicillin-Resistant Staphylococcus aureus (MRSA) Strains Isolated from Clinical Specimens in Kathmandu, Nepal

Background: Methicillin-resistant Staphylococcus aureus (MRSA) refers to a group of Gram-positive bacteria that are genetically distinct from other strains of Staphylococcus aureus and is responsible for several difficult-to-treat infections in humans. It constitutes the most severe contemporary challenges to the treatment of hospital-acquired infections Objective: This study was conducted to determine the prevalence of MRSA among clinical isolates of Methicillinresistant Staphylococcus aureus bacterium and determine the antimicrobial susceptibility pattern. Methods: A cross-sectional study was carried out from March to September 2018 at Everest Hospital, Kathmandu, Nepal, in which 526 samples isolated from various clinical specimens. Methicillin-resistant Staphylococcus aureus (MRSA) identified by using the Cefoxitin (30 μg) disc diffusion method followed by the Clinical and Laboratory Standards Institute (CLSI 2015) guidelines. Results: Most of the MRSA was isolated from pus, which collected from OPD patients. Antibiotic sensitivity pattern showed that all Methicillin-resistant Staphylococcus aureus isolates were sensitive to vancomycin teicoplanin, linezolid, and none of the isolates were sensitive to antibiotic penicillin. At the end of the final observations, 33.8% of clinical samples were positive to S. aureus growth. Conclusion: In this study, the prevalence of MRSA isolates was less as compared to other studies routine screening of MRSA by cefoxitin disc and determining the complete antimicrobial susceptibility profile of these isolates to treat these infections effectively.

Methicillin-Resistant Staphylococcus aureus (MRSA): One Health Perspective Approach to the Bacterium Epidemiology, Virulence Factors, Antibiotic-Resistance, and Zoonotic Impact.

Methicillin-resistant Staphylococcus aureus (MRSA) is a major human pathogen and a historically emergent zoonotic pathogen with public health and veterinary importance. In humans, MRSA commonly causes severe infectious diseases, including food poisoning, pyogenic endocarditis, suppurative pneumonia, otitis media, osteomyelitis, and pyogenic infections of the skin, soft tissues. In the horse, MRSA could cause a localized purulent infection and botryomycosis; in cattle and ewe, localized pyogenic infection and severe acute mastitis with marked toxemia; in sheep, abscess disease resembles caseous lymphadenitis caused by anaerobic strains; in dogs and cats, pustular dermatitis and food poisoning; in pig, exudative epidermatitis “greasy pig disease; in birds, MRSA causes bumble-foot. The methicillin resistance could be determined by PCR-based detection of the mecA gene as well as resistance to cefoxitin. In Egypt, MRSA is one of the important occasions of subclinical and clinical bovine mastitis, and the prevalence of MRSA varies by geographical region. In this review, we are trying to illustrate variable data about the host susceptibility, diseases, epidemiology, virulence factors, antibiotic resistance, treatment, and control of MRSA infection.

English

Methicillin-resistant Staphylococcus aureus (MRSA) is a major hospital acquired pathogen. In Cameroon, there is limited data on nasal carriage of MRSA and its antibiotic susceptibility testing and risk factors for multi resistance to antibiotics in hospitalized patients and medical staff . A prospective, qualitative, cross-sectional hospital-based study was carried out. Anterior nasal swabs were taken from 579 participants and bacterial strains were identified by conventional method and antibiotic susceptibility testing. Methicillin resistance was confirmed with cefoxitin and oxacillin disks. Of the 579 samples analysed, 53.0% were positive for S. aureus, 45.4% were MRSA. MRSA constituted 85.7% of all the S. aureus identified. The prevalence of MRSA in nasal carriage was significantly higher in females (49.6%) than in males (34.0%). The overall prevalence of MRSA in nasal carriage in both medical staff and hospitalized patients was 45.4%. The prevalence of MRSA in nasal carriage was significantly higher in RHL (49.0%) and RHB (48.5%) compared to the UTHY (36.3%). The prevalence of MRSA in nasal carriage was significantly higher in the surgical ward (59.7%) and paediatric ward (45.2%) compared to the other units. Among the MRSA isolates, the maximum sensitivity was observed with vancomycin (97.0%) and minocycline (95.1%), while the least sensitivity was observed with penicillin (0.0%) and ampicillin (0.8%). Binary logistic regression model showed that being aged 35 years an above and being hospitalized for more than 15 days were strongly associated with MDR to MRSA. Nasal carriage of MRSA is increasing rapidly and call for urgent preventive measures. Key words: Healthcare personnel, adult patients, nasal carriage, antibiotic susceptibility, risk factors, health care personnel, adult, patients, multi drug resistance (MDR), methicillin-resistant Staphylococcus aureus (MRSA).

Nasal carriage of methicillin resistant Staphylococcus aureus among medical students of a private institution in Ilishan-Remo, Ogun State, Nigeria

Background: Nasal carriage of methicillin resistant Staphylococcus aureus (MRSA) is a major factor for its transmission especially from the health workers and medical students to their patients. There are a number of published data on the prevalence of MRSA among health workers but data on nasal colonization of medical students by MRSA are sparse in Nigeria. The objectives of this study are to determine the prevalence of nasal carriage of MRSA among medical students of the Ben Carson School of Medicine, Babcock University, Ilishan-Remo, Ogun State, Nigeria, and identify risk factors associated with this nasal carriage.&#x0D; Methodology: A case control study involving 100 clinical (study group) and 100 pre- clinical (control group) medical students was undertaken between March 2018 and October 2019. Structured questionnaire was administered to obtain socio-demographic information and potential risk factors. Nasal swab was collected from each student and cultured for isolation of S. aureus by standard microbiology techniques. Phenotypic MRSA was detected by the cefoxitin 30μg disk diffusion method according to the guideline of Clinical and Laboratory Standards Institute. The mecA gene was detected by conventional polymerase chain reaction (PCR) assay.&#x0D; Results: The prevalence of S. aureus nasal carriage among the study group was 14% (14/100) while the prevalence among the control group was 6% (6/100) (p=0.097). The prevalence of phenotypic MRSA among the study group was 4% (4/100) and 1% (1/100) among the control group (p=0.3687) while mecA gene was detected in 3 of the 4 (75%) phenotypic MRSA positive study participants and in the only (100%) phenotypic MRSA positive (1%) control group. Antibiotics usage without prescription, antibiotic treatment of common cold, and use of antibiotics in the previous one year, were significantly associated with MRSA carriage among the study group.&#x0D; Conclusion: Although the prevalence of nasal carriage of S. aureus and MRSA among clinical and pre-clinical medical students was not statistically significant, the risk factors identified with carriage of MRSA among the study group indicates the need for antimicrobial stewardship program to reduce carriage and transmission of MRSA by medical students.&#x0D; Keywords: methicillin resistant, Staphylococcus aureus, mecA gene, nasal carriage, medical students

Prevalence and anti-microbial susceptibility pattern of methicillin resistant Staphylococcus aureus at a tertiary care hospital

Background: To study about the prevalence and anti-microbial susceptibility pattern of methicillin resistant Staphylococcus aureus (MRSA).Methods: Totally 110 non-repetitive Staphylococcus aureus isolates were enrolled in this study. Isolates from different clinical specimens like pus and blood obtained from patients in tertiary care hospital and Staphylococcus aureus was identified by conventional phenotypic methods. Complete antibiotic susceptibility testing of all MRSA isolates was determined by Kirby-Bauer disc diffusion method.Results: Out of 110 isolates of S. aureus 60 were found to be methicillin-resistant Staphylococcus aureus (MRSA). The prevalence of MRSA was 54%. Out of 60 isolates, male patients 37 (63%) and female patients are 22 (37%). Maximum numbers of isolates 25 (41.6%) were from the age group of 51 to 60 years. Among these 60 isolates, all of them were found to be resistant to penicillin and oxacillin. In contrast, 98% of the isolates were found to be sensitive to linezolid. The sensitivity to chloramphenicol 70%, co-trimoxazole 60%, amikacin 58%, clindamycin 43%, ciprofloxacin 38%, erythromycin 25%.Conclusions: The observed prevalence rate was 54%. Linezolid showed the best therapeutic outcome against MRSA. Active screening plays an important role in control of MRSA.

Characterization of different virulent factors in methicillin-resistant Staphylococcus aureus isolates recovered from Iraqis and Syrian refugees in Duhok city, Iraq.

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem. There is limited information regarding the genetics of MRSA strains among the native Iraqi and incoming Syrian refugee communities. We aimed to characterize the genotypes and different virulence factors of MRSA in strains isolated from these two communities. Frozen MRSA strains (125) isolated from the native Iraqi and Syrian refugee communities were used in this study. PCR (singleplex and multiplex) and agr typing was used for the genotypic analysis of different virulence genes. We tested for the presence of virulence genes including pvl, arcA, tst, lukE/lukD, hla, hlb, eta, etb and agr. Prevalence of arcA MRSA in the Iraqi community (56.58%) was significantly higher (p = 0.008) than that in the Syrian refugee community (32.66%). Prevalence of lukE-lukD was also significantly higher (p = 0.001) in the Iraqi (82.89%) compared to that in the Syrian refugee community (57.14%). Further, prevalence of hla MRSA in the Iraqi community was (93.4%) and in the Syrian refugee community was (71.4%); (p = 0.0008). No significant differences were observed in the prevalence of pvl, tst, eta, etb and hlb. The most dominant agr types in both Iraqi (76.1% and 10.5%) and Syrian refugee (44.9% and 18.37%) communities were I and III. To sum up, no significant differences were observed between the groups for a majority of virulence factors. This is the first investigation of MRSA genotypes and virulence in both these communities. These results could be useful for further studies that assess the genetic relatedness of strains in the region for epidemiological and monitoring purposes, which would be crucial to limiting the spread of MRSA.

Prevalence of methicillin-resistant Staphylococcus aureus colonization in the emergency department health care workers

Introduction: AThe aim of this study was to evaluate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in the health care workers of emergency department of Imam Reza hospital, Tabriz, Iran Methods: In a total of 63 physicians and nurses in the emergency department of Imam Reza hospital, after obtaining written consent and completing a checklist, a sample of nasal mucosa was collected for microbiological examination and isolation of Staphylococcus aureus (SA) strain. Determination of resistance patterns (by diffusion method) was performed according to the standard methods of methicillin. Results: Out of 63 participants, 8 subjects (12.7%) had colonization of S. aureus; 4 of them were physicians (17.3% of the participated physicians) and 4 were nurses (10% of the participated nurses). Out of 8 isolated SA, 2 cases (25%) and overall 3.1% were methicillin-resistant. In our study, there was a significant relationship between co-employment in other hospitals and patient care at home with SA colonization, but there was not a significant relationship with specialty, work experience, sinusitis, history of antibiotic use, history of skin disease, hand washing habits and use of personal protective equipment. Conclusion: Prevalence of MRSA was not high among health workers of emergency department.

Clinico-microbiological study of community acquired MRSA from skin and soft tissue infections and its antibiogram in a tertiary care hospital in Karnataka

Methicillin resistant staphylococcus aureus (MRSA) has always been a worldwide problem, although its prevalence varies considerably among countries. The epidemiology of MRSA has changed over the years and infections are no longer confined to the hospital setting, but appear in healthy community dwelling individuals with no risk factors. From skin and soft tissue infection, common organism isolated is Community associated MRSA (CA-MRSA). Hence the study was done to know the prevalence of MRSA among community associated skin and soft tissue infections in Basaveshwar teaching and general hospital, attached to M.R. Medical College, Gulbarga. Standard techniques were used to isolate Staphylococcus aureus from clinical specimens. Cefoxitin disc diffusion was used to find MRSA. Antibiogram of MRSA was detected by Kirby Bauer disc diffusion method. Inducible Clindamycin resistance was done by Double Disc Diffusion method (D test). From over 200 cases of CA-MRSA, total of (75.5%) staphylococcus aureus was detected. Out of them, CA-MRSA was 27 (17.9%). These showed high sensitivity to Vancomycin (100%), Linezolid (96.2%),Cindamycin (92.59%), moderately susceptible to TMP-SMX(85.1%), Rifampicin (88.1%), Tetracycline(81.4%),Gentamicin (70.3%), ciprofloxacin(62.9%) and a low susceptibility to Erythromycin (48.14%). 14.8% of CA-MRSA strains were D test positive (inducible MLS positive) and 29.63% were D test negative (MS phenotype). 7.4% of CA-MRSA were positive for constitutive MLS resistance. There is a need for judicious selection of antimicrobial agents, as their indiscriminate use can exert pressure in selecting MRSA and other multi-drug resistant organisms. Further spread of community acquired infections can be done by effective infection control programs.

Nasal carriage of various staphylococcal species in small ruminant lentivirus-infected asymptomatic goats.

The study was carried out in Polish goat population to estimate the prevalence of the nasal cavity infection with various staphylococcal species including methicillin-resistant Staphylococcus aureus(MRSA), investigate the potential permissive role of small ruminant lentivirus (SRLV) infection and determine the level of clonality of S. aureus nasal isolates. Nasal swabs and blood samples were collec-ted from 1300 clinically healthy adult goats from 21 Polish goat herds. Blood samples were serological-ly screened for SRLV. Staphylococci were isolated from nasal swabs and identified using classical microbiological methods, MALDI-TOF, multiplex-PCR, and their clonality was assessed using PFGE. Antimicrobial resistance was determined on the basis of minimum inhibitory concentration and by demonstration of the presence of the mecA gene encoding the multiplex-PCR PBP2a protein and of the five main types of staphylococcal cassette chromosome mec. The apparent prevalence of staphylococ-cal and S. aureus infection of the nasal cavity was 29.1% (CI 95%: 26.9%, 31.5%) and 7.3% (CI 95%: 6.1%, 8.8%), respectively. No relationship was found between the SRLV-infection and the presence of any staphylococcal species including S. aureus (p=0.143). Only 9.8% of S. aureus isolates were resistant to amoxicillin/clavulanic acid and 5.9% to chloramphenicol and ciprofloxacin. All tested isolates proved to be phenotypically and genotypically sensitive to methicillin, which yielded the appar-ent prevalence of MRSA of 0% (CI 95%: 0%, 7.0%). S. aureus isolates show high genetic similarity within goat herds, however vary considerably between herds. Goats do not appear to be an important source of S. aureus for humans in Poland.

Prevalence Of Methicillin-Resistant Staphylococci Among Apparently Healthy Students Attending A Tertiary Institution In Benin City, Nigeria

This study was aimed at determining the prevalence of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative staphylococci (MRCoNS) among apparently healthy students of a tertiary institution in Benin City, Nigeria. A total of 350 students were recruited for the study and nasal swabs were collected alongside demographic data. These swabs were processed microbiologically using standard techniques to recover staphylococci. Antimicrobial susceptibility and methicillin-resistance was determined using a phenotypic method (cefoxitin resistance). A total of 148 (42.3%) of 350 students were culture positive for S. aureus, while 72 (20.6%) were positive for CoNS. Students from Faculty of Dentistry showed the highest prevalence of nasal MRSA (40.0%) and MRCoNS (20.0%). Ofloxacin and gentamicin were the most active antibacterial agents against MRSA with 89.1% and 87.3% respectively been susceptible, while gentamicin was the most active antibiotic against MRCoNS (75.0%). Nasal colonization by MRSA and MRCoNS was unaffected by area of residence and gender (P &gt; 0.05). The nasal carriage rate of MRSA and MRCoNS was 37.2% and 33.3% respectively. The study recommends periodic review of nasal colonization rates among apparently healthy subjects. Regulated use of antimicrobial agents is imperative in order to stem the tide of resistance.&#x0D; Keywords: Methicillin-resistance, Staphylococci, Students, Antibiotics

Methicillin-resistant Staphylococcus aureus (MRSA) isolated from raw milk and nasal swabs of small ruminants in Abeokuta, Nigeria.

Methicillin-resistant Staphylococcus aureus (MRSA), an important widespread cause of severe infection in both humans and animals, is a significant pathogen of public health concern. This study examined the presence of MRSA in 400 samples comprising 200 raw milks (145 from goat and 55 from sheep) and 200 nasal swabs (145 from goats and 55 from sheep) collected from ten different locations in Abeokuta, Nigeria. Samples were examined using standard bacteriological methods for the isolation and identification of Staphylococcus aureus and culture on oxacillin (6μg/ml) and cefoxitin (2μg/ml) selective media for the detection of MRSA. Suspected MRSA isolates were confirmed by latex agglutination test for the detection of penicillin-binding protein 2a (PBP2a). Antibiotic susceptibility testing was determined by Kirby Bauer disc diffusion method. Staphylococcus aureus was detected in 72 (18%) of 400 samples of which 52 (13%) were confirmed as MRSA. Methicillin-resistant S. aureus was detected in raw milk (37 of 200; 18.5%) and nasal swab (15 of 200; 7.5%). There was no significance difference (p > 0.05) in the prevalence of MRSA in sheep (37.7%) and goat (23.4%). The MRSA isolates showed resistance to ampicillin (100%), cloxacillin (100%), sulphamethoxazole-trimethoprim (100%), amoxicillin-clavulanate (84.6%), ceftriaxone (75%), cefuroxime (69.2%), erythromycin (65.4%), streptomycin (38.5%), ciprofloxacin (23.1%), pefloxacin (21.2%) and gentamicin (17.3%). The presence of multidrug-resistant MRSA in small ruminants reared in Abeokuta metropolis may be due to regular use of antibiotics and unhygienic practices by farmers. This in turn constitutes a potential public health risk to the owners, consumers of small ruminant products and the general populace.

Prevalence and associated factors for carriage of Enterobacteriaceae producing ESBLs or carbapenemase and methicillin-resistant Staphylococcus aureus in Hong Kong community

ObjectivesWe conducted a cross-sectional study in Hong Kong community to estimate the carriage prevalence, associated factors and genotypes of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E), methicillin-resistant Staphylococcus aureus (MRSA) and carbapenemase-producing Enterobacteriaceae (CPE). MethodsSeemingly healthy subjects were asked to provide nasal, handprint and stool samples from March to April 2017. Isolates were characterized by molecular methods. We used multivariable logistic regression models within a generalized estimating equation framework to identify risk factors for ESBL-E carriage. Characteristics of MRSA/CPE carriage were summarized. ResultsThe prevalence of ESBL-E, MRSA and CPE were 52.8% (104/197), 2.5% (5/197) and 0.5% (1/197) respectively. Most ESBL-E isolates were E. coli (85.6%; 113/132). Most ESBL genes belonged to blaCTX−M-G9 (68.9%) and blaTEM (53.0%) types. Self-reported antibiotic consumption (≥2 courses) in the past six months was associated with ESBL-E carriage (adjusted odds ratio: 4.71–5.47). ConclusionsAbundance of ESBL-E in the community are causes of concern, and antibiotic use is associated with its carriage. Presence of MRSA and CPE in community members without clear healthcare exposure hints on a change in their epidemiology. This study establishes a baseline to formulate infection control policies and future studies in combating antimicrobial resistance.

Methicillin-resistant Staphylococcus aureus (MRSA) isolated from chicken meat and giblets often produces staphylococcal enterotoxin B (SEB) in non-refrigerated raw chicken livers

Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for several difficult-to-treat infections and staphylococcal food poisoning (SFP). This study was conducted to investigate the prevalence and enterotoxigenicity of MRSA in broiler chicken meat and giblets. A total of 5.5% (8/144) of the examined samples were contaminated with mecA positive/mecC negative MRSA, with staphylococcal counts of approximately 102 colony forming units (CFU)/g in breast, leg and gizzard samples and approximately 3.3 × 103 CFU/g in frozen liver samples. Most MRSA isolates (75%, 6/8) harboured the staphylococcal enterotoxin B (seb) gene. Reverse transcription-PCR (RT-PCR) showed that MRSA isolates initiated SEB production in experimentally contaminated chicken livers within 24 h of storage at temperatures over 8 °C. SEB was maximally produced at 24 °C when the MRSA counts reached 7.3 × 103 ± 1.2 × 103 CFU/g sample homogenate. The current study concludes that the main broiler chicken MRSA isolates in Egypt harbour the seb gene. To mitigate possible SEB production, especially in broiler chicken livers, a maximum “out of refrigeration” time limit should be implemented for cold chain poultry products.

Methicillin-resistant Staphylococcus aureus (MRSA) on dispensing counters of community pharmacies in Klang Valley

Staphylococcus aureus has been causing contamination and infection in the hospital and community settings. Methicillin-resistant Staphylococcus aureus (MRSA) was first discovered in the 1960s and epidemics of MRSA were reported soon after the usage of methicillin. The incidence rate of MRSA infections has been increasing for the past 50 years, and community-associated infection may be slowly replacing hospital-associated MRSA strains. This study aimed to investigate the prevalence of MRSA on the dispensing counters of community pharmacies under different settings - community pharmacies in shopping malls and high streets in Klang Valley. With verbal consent, swab samples were collected from dispensing counters of 23 community pharmacies using sterile cotton buds moistened with sterile sodium chloride (NaCl) solution. Samples were spread on nutrient agars and Brilliance MRSA 2 selection agars and incubated at 37oC. The numbers of colony were documented and statistically analysed using Microsoft Excel and Statistical Package for the Social Sciences (SPSS) Statistics. The results showed that the prevalence of MRSA on the dispensing counters was 22% (5 out of 23), and the difference in MRSA contamination between community pharmacies in shopping mall and high street setting was insignificant (p > 0.05). This study serves as the pioneer study of its kind in Klang Valley. All healthcare professionals and individuals are strongly advised to practise a good level of hygiene to avoid MRSA cross contamination.