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Although studies have shown that human migration is one of the risk factors for the spread of drug-resistant organisms such as methicillin-resistant  Staphylococcus aureus  (MRSA), surveillance studies examining MRSA among refugee populations in the US are lacking. This study aimed to assess the prevalence and molecular characteristics of  S. aureus  among Bhutanese refugees living in Nepal and resettled in Northeast Ohio (NEO). One hundred adult Bhutanese refugees from each geographic location were enrolled between August 2015 and January 2016. The participants were interviewed to collect demographic information and potential risk factors for carriage. Nasal and throat swabs were collected for bacterial isolation. All  S. aureus  isolates were characterized by  spa  typing and tested for the presence of Panton-Valentine leukocidin (PVL) and  mec A genes; selected isolates were tested by multilocus sequence typing (MLST). The overall prevalence of  S. aureus  was 66.0% and 44.0% in NEO and Nepal, respectively. In Nepal, 5.8% (3/52) of isolates were MRSA and 1.1% (1/88) in NEO. Twenty-one isolates in NEO (23.9%) were multidrug-resistant  S. aureus  (MDRSA), while 23 (44.2%) in Nepal were MDRSA. In NEO, 41  spa  types were detected from 88  S. aureus  isolates. In Nepal, 32  spa  types were detected from 52  S. aureus  isolates.  spa  types t1818 and t345 were most common in NEO and Nepal, respectively. The overall prevalence of PVL-positive isolates among  S. aureus  in Nepal and NEO was 25.0% and 10.2%. ST5 was the most common sequence type in both locations. Bhutanese refugees living in Nepal and resettled in NEO had high prevalence of  S. aureus  and MDRSA. The findings suggest a potential need for CA-MRSA surveillance among the immigrant population in the U S and among people living in Nepal, and a potential need to devise appropriate public health measures to mitigate the risk imposed by community-associated strains of  S. aureus  and MRSA.

biomed research international

Multidrug-resistant<i>Staphylococcus aureus</i>Colonization in Healthy Adults Is more Common in Bhutanese Refugees in Nepal than Those Resettled in Ohio

Multidrug-resistantStaphylococcus aureusColonization in Healthy Adults Is more Common in Bhutanese Refugees in Nepal than Those Resettled in Ohio