title: Staphylococcus aureus nasal carriage among outpatients attending primary health care centers: a comparative study of two cities in Saudi Arabia and Egypt.
abstract: Epidemiological and molecular data on community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) are still scarce in both Egypt and Saudi Arabia. There is almost no data regarding methicillin resistant Staphylococcus aureus (MRSA) prevalence in both countries. This study was conducted to investigate the prevalence and molecular epidemiology of S. aureus and MRSA nasal carriage among outpatients attending primary health care centers in two big cities in both countries. A total of 206 nasal swabs were obtained, 103 swabs from each country. S. aureus isolates were characterized by antibiotic susceptibility, presence of mecA and PVL genes, SCCmec-typing and spa typing, the corresponding Multi locus sequence typing clonal complex was assigned for each spa type based on Ridom StaphType database. MRSA was detected in 32% of the Egyptian outpatients while it was found in 25% of the Saudi Arabian outpatients. All MRSA isolates belonged to SCCmec type V and IVa, where some isolates in Saudi Arabia remained nontypeable. Surprisingly PVL(+) isolates were low in frequency: 15% of MRSA Egyptian isolates and 12% of MRSA isolates in Saudi Arabia. Two novel spa types were detected t11839 in Egypt, and t11841 in Saudi Arabia. We found 8 spa types among 20 isolates from Egypt, and 12 spa types out of 15 isolates from Saudi Arabia. Only two spa types t008 and t223 coexisted in both countries. Four clonal complexes (CC5, CC8, CC22, and CC80) were identified in both Egypt and Saudi Arabia. However, the data collected lacked a representation of isolates from different parts of each country as only one health center from each country was included, it still partially illustrates the CA-MRSA situation in both countries. In conclusion a set of control measures is required to prevent further increase in MRSA prevalence.
authors.affiliation: Department of Microbiology, Faculty of Science, Ain Shams University, Cairo, Egypt.
authors.forename: Hala M
authors.initials: HM
authors.lastname: Abou Shady
authors.affiliation: Department of Microbiology, Faculty of Science, Ain Shams University, Cairo, Egypt; Environmental Quality Sector, Egyptian Environmental Affairs Agency, Cairo, Egypt. Electronic address: alaagul@yahoo.com.
authors.forename: Alaa Eldin A
authors.initials: AE
authors.lastname: Bakr
authors.affiliation: Department of Microbiology, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt.
authors.forename: Mahmoud E
authors.initials: ME
authors.lastname: Hashad
authors.affiliation: Department of Medical Laboratories, College of Applied Medical Science, Qassim University, Qassim, Saudi Arabia.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Alzohairy
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000382:microbiology*; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000235:genetics; D004534:Egypt; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D009296:Nasal Cavity / Q000382:microbiology*; D010045:Outpatients; D010802:Phylogeny; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012529:Saudi Arabia; D013203:Staphylococcal Infections / Q000382:microbiology; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D037521:Virulence Factors
keywords: Community acquired methicillin resistant Staphylococcus aureus (CA-MRSA); Outpatients in Egypt and Saudi Arabia; SCCmec typing; Spa typing