title: Inducible clindamycin resistance and nasal carriage rates of Staphylococcus aureus among healthcare workers and community members.
abstract: BACKGROUND
  Nasal carriage of Staphylococcus aureus is becoming an increasing problem among healthcare workers and community individuals.
  
  
  OBJECTIVE
  To determine the prevalence of methicillin-resistant S. aureus (MRSA) nasal colonization and inducible clindamycin resistance (ICR) of S. aureus among healthcare workers at Soba University Hospital and community members in Khartoum State, Sudan.
  
  
  METHODS
  Five hundred nasal swabs samples were collected during March 2009 to April 2010. Isolates were identified using conventional laboratory assays and MRSA determined by the disk diffusion method. The D-test was performed for detection of ICR isolates with Clinical Laboratory Standard Institute guidelines.
  
  
  RESULTS
  Of the 114 S. aureus isolated, 20.2% represented MRSA. The occurrence of MRSA was significantly higher among healthcare worker than community individuals [32.7% (18/55) vs. 6.9% (5/59)] (p=0.001). Overall the 114 S. aureus isolates tested for ICR by D-test, 29 (25.4%) yielded inducible resistance. Significantly higher (p=0.026) ICR was detected among MRSA (43.5%) than methicillin-susceptible S. aureus (MSSA) (20.9%).
  
  
  CONCLUSIONS
  MRSA nasal carriage among healthcare workers needs infection control practice in hospitals to prevent transmission of MRSA. The occurrence of ICR in S. aureus is of a great concern, D- test should be carried out routinely in our hospitals to avoid therapeutic failure.
authors.affiliation: Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Khartoum University, Sudan.
authors.forename: Alaa M
authors.initials: AM
authors.lastname: Mahmoud
authors.affiliation: Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Khartoum University, Sudan.
authors.forename: Hanaa S
authors.initials: HS
authors.lastname: Albadawy
authors.affiliation: Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Khartoum University, Sudan.
authors.forename: Samira M
authors.initials: SM
authors.lastname: Bolis
authors.affiliation: Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Khartoum University, Sudan.
authors.forename: Naser E
authors.initials: NE
authors.lastname: Bilal
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah Al Mukarramah, Saudi Arabia.
authors.forename: Abdalla O
authors.initials: AO
authors.lastname: Ahmed
authors.affiliation: Department of Medical Microbiology and Parasitology, College of Medicine, University of Bisha, Kingdom of Saudi Arabia.
authors.forename: Mutasim E
authors.initials: ME
authors.lastname: Ibrahim
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002353:Carrier State / Q000453:epidemiology*; D002981:Clindamycin / Q000494:pharmacology*; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control*; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D009666:Nose / Q000382:microbiology; D015995:Prevalence; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D013397:Sudan / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin
keywords: S. aureus nasal carriage; community members; healthcare workers; inducible clindamycin resistance