Journal of Epidemiology and Global Health

<Previous Article In Issue
Next Article In Issue>
Volume 3, Issue 3, September 2013, Pages 165 - 173

Prevalence and characteristics of community carriage of methicillin-resistant Staphylococcus aureus in Malta

Authors
Jeanesse Scerria, Stefan Moneckeb, Michael A. Borgc, *, michael.a.borg@gov.mt
aDept. of Pathology, Mater Dei Hospital, Msida, Malta
bInstitute for Medical Microbiology and Hygiene, Dresden University of Technology, Dresden, Germany/Alere Technologies, Jena, Germany
cMater Dei Hospital and University of Malta, Msida, Malta
*Corresponding author. Address: Infection Control Department, Mater Dei Hospital, Msida MSD2090, Malta.
Corresponding Author
Michael A. Borgmichael.a.borg@gov.mt
Received 6 September 2012, Revised 27 May 2013, Accepted 29 May 2013, Available Online 10 July 2013.
DOI
10.1016/j.jegh.2013.05.003How to use a DOI?
Keywords
MRSA; Antibiotics; Surveillance; Colonization
Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen worldwide. Malta is one of the countries with the highest MRSA prevalence in Europe, as identified from hospital blood cultures [1]. However, community prevalence of MRSA has never previously been investigated. This study aimed at establishing the prevalence of community MRSA nasal colonization in Maltese individuals and identifying the clonal characteristics of the detected isolates. Nasal swabs were collected from 329 healthy individuals who were also asked to complete a brief questionnaire about risk factors commonly associated with MRSA carriage and infection. The swabs were transported and enriched in a nutrient broth supplemented with NaCl. The presence of MRSA was then determined by culturing on MRSA Select chromogenic agar and then confirming by several assays, including catalase, coagulase and PBP2a agglutination tests. The isolates were assayed for antibiotic susceptibilities and typed by microarray analysis to determine the clonal characteristics of each strain. The prevalence of MRSA nasal colonization in the healthy Maltese population was found to be 8.81% (95% confidence interval [CI], 5.75–11.87%), much higher than that found in other studies carried out in several countries. No statistical association was found between MRSA carriage and demographics or risk factors; however, this was hindered by the small sample size. Almost all the isolates were fusidic-acid resistant. The majority were found to belong to a local endemic clone (CC5) which seems to be replacing the previously prevalent European clone UK-EMRSA-15 in the country. A new clone (CC50-MRSA-V) was also characterized. The presence of such a significant community reservoir of MRSA increases the burdens already faced by the local healthcare system to control the MRSA epidemic. Colonization of MRSA in otherwise healthy individuals may represent a risk for endogenous infection and transmission to hospitalized patients after admission to a healthcare facility, leading to longer hospital stays and, consequently, increased healthcare costs.

Copyright
© 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd.
Open Access
Open access under CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/

Download article (PDF)
View full text (HTML)

<Previous Article In Issue
Next Article In Issue>
Journal
Journal of Epidemiology and Global Health
Volume-Issue
3 - 3
Pages
165 - 173
Publication Date
2013/07/10
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
10.1016/j.jegh.2013.05.003How to use a DOI?
Copyright
© 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd.
Open Access
Open access under CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/

Cite this article

risenwbib
TY  - JOUR
AU  - Jeanesse Scerri
AU  - Stefan Monecke
AU  - Michael A. Borg
PY  - 2013
DA  - 2013/07/10
TI  - Prevalence and characteristics of community carriage of methicillin-resistant Staphylococcus aureus in Malta
JO  - Journal of Epidemiology and Global Health
SP  - 165
EP  - 173
VL  - 3
IS  - 3
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2013.05.003
DO  - 10.1016/j.jegh.2013.05.003
ID  - Scerri2013
ER  -