title: Detection of Panton-Valentine Leukocidin-Positive Methicillin-Resistant Staphylococcus aureus Nasal Carriage among Egyptian Health Care Workers.
abstract: BACKGROUND
  Transmission of methicillin-resistant Staphylococcus aureus (MRSA) among patients is linked mainly to health care personnel. The Panton-Valentine leukocidin (PVL) is a cytotoxin that causes leukocyte lysis. Virulence of pvl-positive-MRSA has been attributed to its ability to express PVL toxin.
  
  
  METHODS
  Swabs for detection of nasal carriage of pvl-positive MRSA among health care personnel at Fayoum University Hospital, Fayoum, Egypt, were collected from 223 health care personnel including 70 doctors (31.4%), 95 nurses (42.6%), 21 laboratory technicians (9.4%), and 37 housekeeping staff (16.6%). Detection of MRSA was done using conventional screening methods and confirmed by multiplex polymerase chain reaction (PCR) for mecA, or its homologue mecC, and pvl genes amplification. Re-swabbing after decolonization therapy was done to evaluate the efficacy of decolonization therapy.
  
  
  RESULTS
  Fifty-one of 223 participants (22.9%) were colonized with S. aureus. This included 13.5% (30/223) colonized with MRSA and 2.2% (5/223) colonized with PVL-positive MRSA. Moreover, all MRSA isolates were negative for mecC genes. Decolonization therapy was successful in 80% of MRSA carriers including all pvl-positive MRSA carriers.
  
  
  CONCLUSIONS
  This is the first report on nasal carriage of pvl-positive MRSA among Egyptian health care personnel. High carriage rate of MRSA among health care personnel has been attributed mainly to poor hand hygiene compliance and non-judicious use of antibiotics. Improving compliance, reducing antibiotic overuse, screening for carriers, and decolonization are recommended strategies for reducing the spread of MRSA. Multiplex PCR could be used for confirmation of results obtained by conventional phenotypic methods.
authors.affiliation: 1 Department of Medical Microbiology and Immunology, Faculty of Medicine, Fayoum University , Fayoum, Egypt .
authors.forename: Enas Mamdouh
authors.initials: EM
authors.lastname: Hefzy
authors.affiliation: 2 Genetics Department, Faculty of Agriculture, Fayoum University , Fayoum, Egypt .
authors.forename: Gamal Mohamedin
authors.initials: GM
authors.lastname: Hassan
authors.affiliation: 3 Department of Clinical Pathology, Faculty of Medicine, Fayoum University , Fayoum, Egypt .
authors.forename: Fadwa
authors.initials: F
authors.lastname: Abd El Reheem
mesh_terms: D000293:Adolescent; D000328:Adult; D001427:Bacterial Toxins / Q000235:genetics*; D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000032:analysis; D004534:Egypt; D005098:Exotoxins / Q000235:genetics*; D005260:Female; D005819:Genetic Markers; D006801:Humans; D007956:Leukocidins / Q000235:genetics*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D009297:Nasal Mucosa / Q000382:microbiology*; D010564:Personnel, Hospital; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
chemical_list: D001427:Bacterial Toxins; D004269:DNA, Bacterial; D005098:Exotoxins; D005819:Genetic Markers; D007956:Leukocidins; C078284:Panton-Valentine leukocidin