Detection and antibiotic resistance pattern of Staphylococcus aureusand (MRSA) isolated from healthcare workers Nares at three Gaza hospitals, Palestine

Background: Staphylococcus aureus is a significant cause of nosocomial morbidity and mortality and has been identified as an emerging problem in the community. Here we detect the carriage rate and antibiotic resistance pattern of S. aureus and MRSA isolated from 140 healthcare workers (HCWs) nares at Gaza hospitals.Methods: A cross sectional study was conducted on a total of 140 HCWs. S. aureus were recovered and identified from nasal swabs by conventional and molecular laboratory techniques. Susceptibility to 13 commonly used antibiotics against S. aureus infections was determined by disk diffusion test according to the CLSI guidelines. Testing by PCR for the presence of nuc, mecA, cap5 and cap8 genes was performed on all isolates.Results: The nasal carriage rate of S. aureus was 42.1% (59/140), of MRSA was 22.6% (32/140) and of MSSA was 19.3% (27/140), with the highest carriage rate of MRSA among HCWs from surgery wards. There was no significant difference between the gender or hospitals with regard to S. aureus and MRSA carriage rate. However, a statistically significant difference was found for ward type and work experience. All 59 strains of S. aureus were sensitive to vancomycin and doxycycline, while nearly all were resistant to penicillin and ampicillin. The antibiotic resistance among MRSA was much higher than that among MSSA with a statistically significant difference for most antibiotics tested. Nearly 61% of isolates were noted to be multidrug resistant with higher percentage in MRSA (24/32; 75%) in comparison to MSSA (12/27; 44,44%). All isolates were successfully genotyped for capsular polymorphism type 5 (55.9%) and type 8 (44.1%).Conclusion: This is the first study in Gaza Strip investigating the nasal carriage of S. aureus among HCWs. High number of MRSA isolates were shown to be MDR. These results highlight the critical need for screening and tracking MRSA among HCWs and to monitor and manage the usage of antibiotics in the hospitals and community.