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Published in: BMC Infectious Diseases 1/2016

Open Access 01-12-2016 | Research article

Prevalence of nasal colonisation by methicillin-sensitive and methicillin-resistant Staphylococcus aureus among healthcare workers and students in Madagascar

Authors: Benedikt Hogan, Raphael Rakotozandrindrainy, Hassan Al-Emran, Denise Dekker, Andreas Hahn, Anna Jaeger, Sven Poppert, Hagen Frickmann, Ralf Matthias Hagen, Volker Micheel, Sabine Crusius, Jean Noel Heriniaina, Jean Philibert Rakotondrainiarivelo, Tsiriniaina Razafindrabe, Jürgen May, Norbert Georg Schwarz

Published in: BMC Infectious Diseases | Issue 1/2016

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Abstract

Background

Methicillin-resistant Staphylococcus aureus (MRSA) clones pose a significant threat to hospitalised patients because the bacteria can be transmitted by asymptomatic carriers within healthcare facilities. To date, nothing is known about the prevalence of S. aureus and MRSA among healthcare workers in Madagascar.
The objective of our study was to examine the prevalence and clonal epidemiology of nasal S. aureus and MRSA among healthcare workers and non-medical University students in Antananarivo, Madagascar.

Methods

This cross sectional study screened nasal swabs taken from students and healthcare workers for S. aureus. Multiplex PCR was performed to identify S. aureus-specific (nuc), MRSA-specific mecA and mecC genes, Panton-Valentine leukocidin (PVL) (lukF-PV), and toxic shock syndrome toxin-1 (TSST-1) specific genes in methicillin-sensitive S. aureus (MSSA) and MRSA isolates. Staphylococcus protein A gene (spa) typing was performed for all confirmed MRSA isolates. The frequency distribution of nasal S. aureus and MRSA of healthcare workers and non-medical students was compared using Pearson’s χ2 test.

Results

Of 1548 nasal swabs tested, 171 (11 %) were positive for S. aureus; 20 (1.3 %) of these isolates were identified as MRSA. S. aureus was detected in 91 of 863 healthcare workers (10.4 %) and in 80 (11.8 %) of 685 students; however, 14 (1.5 %) healthcare workers carried MRSA compared with six (0.9 %) students. Nasal carriage of S. aureus and MRSA was more prevalent in women than in men, and 21 (11.7 %) S. aureus isolates were PVL-positive and 36 (21 %) were TSST-1 positive. The mecC gene was not detected in any isolates. Five different spa types were identified, with spa type t186 being the predominant MRSA clone (16/20).

Conclusion

The results of the present study reveal a low frequency of S. aureus and MRSA nasal carriage in both students and healthcare workers from Antananarivo, Madagascar. The predominant MRSA clone (t186) was previously described in hospitalised patients in Madagascar.
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Metadata
Title
Prevalence of nasal colonisation by methicillin-sensitive and methicillin-resistant Staphylococcus aureus among healthcare workers and students in Madagascar
Authors
Benedikt Hogan
Raphael Rakotozandrindrainy
Hassan Al-Emran
Denise Dekker
Andreas Hahn
Anna Jaeger
Sven Poppert
Hagen Frickmann
Ralf Matthias Hagen
Volker Micheel
Sabine Crusius
Jean Noel Heriniaina
Jean Philibert Rakotondrainiarivelo
Tsiriniaina Razafindrabe
Jürgen May
Norbert Georg Schwarz
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2016
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-016-1733-6

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