title: Methicillin-Resistant Staphylococcus aureus Recovered from Healthcare- and Community-Associated Infections in Egypt.
abstract: Background. Methicillin-resistant Staphylococcus aureus (MRSA) has created significant epidemiological, infection-control, and therapeutic management challenges during the past three decades. Aim. To analyze the pattern of resistance of healthcare- and community-associated MRSA in Egypt and the trend of resistance of HA-MRSA over time (2005-2013). Methods. MRSA isolates were recovered from healthcare-associated (HA) and community-associated (CA) Staphylococcus aureus (S. aureus) infections. They were tested against 11 antimicrobial discs and the minimal inhibitory concentration (MIC) of vancomycin was determined. Inducible clindamycin resistance (iMLSB) was also screened using D-test. Findings. Of 631 S. aureus, MRSA was identified in 343 (76.6%) and 21 (11.5%) of HA and CA S. aureus isolates, respectively. The proportion of HA-MRSA increased significantly from 48.6% in 2005 to 86.8% in 2013 (p value < 0.001). Multidrug resistance (MDR) was observed in 85.8% of HA-MRSA and 48.6% of CA-MRSA. Vancomycin intermediate resistant S. aureus (VISA) was detected in 1.2% of HA-MRSA and none was detected in CA-MRSA. Among HA-MRSA strains, 5.3% showed iMLSB compared to 9.5% among CA-MRSA. Conclusion. The upsurge of the prevalence rates of HA-MRSA over time is alarming and urges for an effective infection control strategy and continuous monitoring of antimicrobial use.
authors.affiliation: US Naval Medical Research Unit No. 3, Cairo 11517, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Maksoud
authors.affiliation: US Naval Medical Research Unit No. 3, Cairo 11517, Egypt; Global Disease Detection Center, US Centers for Disease Control and Prevention, Cairo, Egypt; Ain Shams University, Cairo 11566, Egypt.
authors.forename: Mona
authors.identifier: 0000-0001-9569-8111
authors.initials: M
authors.lastname: El-Shokry
authors.affiliation: Ain Shams University, Cairo 11566, Egypt.
authors.forename: Ghada
authors.initials: G
authors.lastname: Ismail
authors.affiliation: Alexandria University, Alexandria 21599, Egypt.
authors.forename: Soad
authors.initials: S
authors.lastname: Hafez
authors.affiliation: Cairo University, Cairo 12316, Egypt.
authors.forename: Amani
authors.initials: A
authors.lastname: El-Kholy
authors.affiliation: Ministry of Health and Population, Cairo 11516, Egypt.
authors.forename: Ehab
authors.initials: E
authors.lastname: Attia
authors.affiliation: US Naval Medical Research Unit No. 3, Cairo 11517, Egypt; Global Disease Detection Center, US Centers for Disease Control and Prevention, Cairo, Egypt.
authors.forename: Maha
authors.initials: M
authors.lastname: Talaat