الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
S. aureus is one of the most dangerous pathogens responsible for serious life-threatening infections from minor skin infections. Its treatment has become more challenging and treatment options are decreasing over time.
MRSA is one of the most important endemic pathogens acquired in hospitals and communities. This growing trend has been followed by increased use of vancomycin; the drug of choice for MRSA infection treatment.
The present study aimed to: 1- Isolate and identify S. aureus from anterior nares and hands of HCWs.
3- Perform antibiotic susceptibility testing for all S. aureus isolates.
The following samples were collected:
- Nasal swabs were collected from HCWs and then were immediately inoculated on mannitol salt agar plates.
- Hand finger print samples were collected by rolling the fingertips of HCWs over the surface of blood agar plate.
After proper incubation, identification of isolated colonies was performed according to the standard microbiological methods. All S. aureus isolates were subjected to antibiotic susceptibility testing by disc diffusion method. The prevalence of vancomycin resistance among S. aureus was determined using MIC by agar dilution method.
The results of the present study revealed that:
1- The overall mean age of the HCWs was 37.05±11.1, while the overall mean number of years in the current position was 13.9±11.1.
2- Out of the total 430 HCWs, only 14.2% and 5.1% were S. aureus nasal and hand carriers, respectively. About 10.5% of the HCWs were carriers of methicillin-resistant S. aureus (MRSA) in their nares and 4.2% on hands.
3- There was no significant association between S. aureus and MRSA nasal carriage with the age of HCWs.
4- There was a significant association between S. aureus hand carriage and age of HCWs, while there was no significant association between MRSA hand carriage and age of HCWs.
5- There was a significant difference in nasal carriage of S. aureus in males (21%) which was higher than females (11.4%). The nasal carriage rate of MRSA among males was 17.7% whereas it was 7.5% among females.
6- The prevalence of S. aureus on hands was 4.8% and 5.2% for males and female HCWs respectively. It was found that MRSA hand carriage with approximately equal distribution among both genders.
7- The highest prevalence of S. aureus nasal carriage was among physicians (21.8%) and the least was among nurses (12.7%), while MRSA nasal carriage was particularly high among physicians (20%), workers (9.6%) and nurses (9%). Pharmacists (6 HCWs) showed no MRSA carriage.
8- The highest prevalence of S. aureus hand carriage was among physicians (10.9%) and the least was among workers (4%), MRSA hand carriage was also significantly high among physicians (10.9%), nurses (4.5%) and workers (0.8%). Pharmacists showed no MRSA carriage.
9- Based on HCWs profession, the highest rate of nasal S. aureus carriers (20%) and MRSA carriers (15%) were among HCWs in surgical departments. The highest rate of hand S. aureus carriers (6.5%) and MRSA carriers (5.5%) were also among HCWs in surgical departments.
10- There was no significant association between S. aureus and MRSA nasal carriage and time spent in the current position.
11- There was a significant association between S. aureus hand carriage and time spent in the current position, while there was no significant association between MRSA hand carriage and time spent in the current position.
12- Among the 83 S. aureus nasal and hand isolates, 75.9%were resistant to methicillin, while they were 100% sensitive to vancomycin, ciprofloxacin, mupirocin and linezolid.
It can be concluded from the present study that:
1- There was a significant association between the gender and carriage of S. aureus and MRSA, where the present study showed that males had higher carriage rate of S. aureus and MRSA compared to females.
2- Based on HCWs profession, the highest rate of nasal S. aureus carriers and MRSA carriers were among HCWs in surgical departments.
3- There was a significant association between age and hand carriage of S. aureus among HCWs.
4- There was a significant association between time spent in the current position and hand carriage of S. aureus.
5- There was no significant difference between nasal and hand S. aureus isolates regarding susceptibility to antibiotics.
from the results of the present study, the following recommendations are suggested:
1- Further studies are recommended with larger sample size and more homogenous sample for assessment of risk factors of hand and nasal colonization.
2- Regular screening of HCWs for S. aureus and MRSA.
3- Decolonization of carriers and treatment in case of proper antibiotics were administrated.