title: Occupational exposure of pharmaceutical workers to drug actives and excipients and their effect on Staphylococcus spp. nasal carriage and antibiotic resistance.
abstract: BACKGROUND
  Pharmaceutical manufacturing workers are exposed to significant amounts of product ingredients, including antibiotics. Such exposure could affect their nasal microflora.
  
  
  OBJECTIVE
  To assess the effect of exposure to various unidentified pharmaceutical ingredients in cephalosporin-manufacturing and non-cephalosporin plants on the nasal carriage of Staphylococcus spp. and their antibiotic resistance.
  
  
  METHODS
  Nasal swab samples were collected from 39 workers in both plants on three different occasions. Staphylococci were isolated and identified to genus level. Antibiotic resistance profiles were determined and subsequent identification to species level was performed.
  
  
  RESULTS
  There was complete absence of S. aureus in the samples collected from workers in both facilities. Multiple drug resistant coagulase-negative staphylococci (MDR CONS) prevalence rates were higher in the non-cephalosporin plant than in the cephalosporin plant, with resistance towards six classes of antibiotics. S. epidermidis was the prevalent species in the non-cephalosporin plant and S. haemolyticus prevailed in the cephalosporin-producing plant.
  
  
  CONCLUSIONS
  The observed prevalence of CONS in both production plants was the same. However, exposure to intermittent non-cephalosporin pharmaceuticals results in higher prevalence of MDR CONS compared to continuous exposure to cephalosporin.
authors.affiliation: The University of Jordan, Amman, Jordan.
authors.forename: Randa N
authors.initials: RN
authors.lastname: Haddadin
authors.forename: Suhair A
authors.initials: SA
authors.lastname: Saleh
authors.forename: Manal A
authors.initials: MA
authors.lastname: Ayyash
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Collier
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002353:Carrier State / Q000382:microbiology*; D002511:Cephalosporins / Q000494:pharmacology; D004345:Drug Industry; D024881:Drug Resistance, Bacterial; D005079:Excipients / Q000494:pharmacology; D006801:Humans; D009296:Nasal Cavity / Q000382:microbiology; D009784:Occupational Diseases / Q000382:microbiology*; D016273:Occupational Exposure / Q000032:analysis*; D013203:Staphylococcal Infections / Q000382:microbiology*; D013210:Staphylococcus / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D005079:Excipients