title: Molecular analysis and susceptibility patterns of methicillin-resistant Staphylococcus aureus strains causing community- and health care-associated infections in the northern region of Palestine.
abstract: BACKGROUND
  Community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a major global problem. This study attempted to investigate the prevalence of nasal carriage of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) strains among 360 healthy university students at An-Najah National University, Palestine. For the purpose of comparing the staphylococcal cassette chromosome methicillin resistant determinant (SCCmec) type of MRSA, 46 clinical MRSA isolates were also included in this study.
  
  
  METHODS
  Susceptibility testing was performed by the disc diffusion method. The genetic association of MRSA isolates was investigated by SCCmec typing. A selected number of isolates were also used to amplify and sequence mecA.
  
  
  RESULTS
  Nasal carriage of S aureus was found in 86 of 360 students (24%). MRSA accounted for 9% of S aureus isolates. All 86 strains of S aureus were sensitive to vancomycin. Resistance to penicillin G, amoxicillin/clavulanic acid, ciprofloxacin, erythromycin, and clindamycin was found in 98%, 93%, 33%, 23%, and 12% of the isolates, respectively. Resistance rates of the MRSA isolates were as follows: 100% resistant to penicillin G and amoxicillin/clavulanic acid, 96% to ethromycin, 52% to clindamycin, and 48% to ciprofloxacin. No vancomycin-resistant isolates were identified. In our study, nearly half (52%) of the MRSA isolates belonged to SCCmec types IVa and V. However, SCCmec types II and III are represented by 48%, whereas SCCmec type I was completely absent.
  
  
  CONCLUSIONS
  The findings of this study indicate the existence of SCCmec type IVa in both student nasal carriers and health care settings. This emphasizes the need for implementation of a revised set of control measures in both settings. Moreover, the rational prescription of appropriate antibiotics should also be considered.
authors.affiliation: Department of Biology and Biotechnology, An-Najah National University, Nablus, Palestine. adwank@najah.edu
authors.forename: Kamel
authors.initials: K
authors.lastname: Adwan
authors.forename: Naser
authors.initials: N
authors.lastname: Jarrar
authors.forename: Awni
authors.initials: A
authors.lastname: Abu-Hijleh
authors.forename: Ghaleb
authors.initials: G
authors.lastname: Adwan
authors.forename: Elena
authors.initials: E
authors.lastname: Awwad
authors.forename: Yousef
authors.initials: Y
authors.lastname: Salameh
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D008877:Middle East / Q000453:epidemiology; D058889:Molecular Typing; D009296:Nasal Cavity / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013334:Students; D014495:Universities; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents