Pathare Nirmal A, Tejani Sara, Asogan Harshini, Al Mahruqi Gaitha, Al Fakhri Salma, Zafarulla Roshna, Pathare Anil V
Oman Medical College, Muscat, Oman.
Sultan Qaboos University Hospital, Muscat, Oman.
Mediterr J Hematol Infect Dis. 2015 Oct 7;7(1):e2015053. doi: 10.4084/MJHID.2015.053. eCollection 2015.
The prevalence of community-associated methicillin-resistant Staphylococcus aureus [CA-MRSA] is unknown in Oman.
Nasal and cell phones swabs were collected from hospital visitors and health-care workers on sterile polyester swabs and directly inoculated onto a mannitol salt agar containing oxacillin, allowing growth of methicillin-resistant microorganisms. Antibiotic susceptibility tests were performed using Kirby Bauer's disc diffusion method on the isolates. Minimum inhibitory concentration (MIC) was determined for vancomycin and teicoplanin against the resistant isolates of MRSA by the Epsilometer [E] test. A brief survey questionnaire was requested be filled to ascertain the exposure to known risk factors for CA-MRSA carriage.
Overall, nasal colonization with CA-MRSA was seen in 34 individuals (18%, 95% confidence interval [CI] =12.5%-23.5%), whereas, CA-MRSA was additionally isolated from the cell phone surface in 12 participants (6.3%, 95% CI =5.6%-6.98%). Nasal colonization prevalence with hospital-acquired [HA] MRSA was seen in 16 individuals (13.8%, 95% confidence interval [CI] =7.5%-20.06%), whereas, HA-MRSA was additionally isolated from the cell phone surface in 3 participants (2.6%, 95% CI =1.7-4.54). Antibiotic sensitivity was 100% to linezolid and rifampicin in the CA-MRSA isolates. Antibiotic resistance to vancomycin and clindamycin varied between 9-11 % in the CA-MRSA isolates. Mean MIC for vancomycin amongst CA- and HA-MRSA were 6.3 and 9.3 μg/ml, whereas for teicoplanin they were 13 and 14 μg/ml respectively by the E-test. There was no statistically significant correlation between CA-MRSA nasal carriage and the risk factors (P>0.05, Chi-square test).
The prevalence of CA-MRSA in the healthy community hospital visitors was 18 % (95% CI, 12.5% to 23.5%) as compared to 13.8% HA-MRSA in the hospital health-care staff. Despite a significant prevalence of CA-MRSA, these strains were mostly sensitive.
The universal techniques of hand washing, personal hygiene and sanitation are thus warranted.
阿曼社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）的流行情况尚不清楚。
用无菌聚酯拭子从医院访客和医护人员处采集鼻腔和手机拭子，直接接种到含苯唑西林的甘露醇盐琼脂上，以使耐甲氧西林微生物生长。对分离株采用 Kirby Bauer 纸片扩散法进行药敏试验。通过 E 试验测定万古霉素和替考拉宁对耐甲氧西林金黄色葡萄球菌耐药分离株的最低抑菌浓度（MIC）。要求填写一份简短的调查问卷，以确定是否接触过已知的 CA-MRSA 携带风险因素。
总体而言，34 人（18%，95%置信区间[CI]=12.5%-23.5%）鼻腔定植有 CA-MRSA，而 12 名参与者（6.3%，95%CI=5.6%-6.98%）的手机表面也分离出 CA-MRSA。16 人（13.8%，95%置信区间[CI]=7.5%-20.06%）鼻腔定植有医院获得性（HA）MRSA，3 名参与者（2.6%，95%CI=1.7-4.54%）的手机表面也分离出 HA-MRSA。CA-MRSA 分离株对利奈唑胺和利福平的药敏率为 100%。CA-MRSA 分离株对万古霉素和克林霉素的耐药率在 9%-11%之间。通过 E 试验，CA-MRSA 和 HA-MRSA 中万古霉素的平均 MIC 分别为 6.3 和 9.3μg/ml，替考拉宁的平均 MIC 分别为 13 和 14μg/ml。CA-MRSA 的鼻腔携带与风险因素之间无统计学显著相关性（P>0.05，卡方检验）。
健康社区医院访客中 CA-MRSA 的流行率为 18%（95%CI，12.5%至 23.5%），而医院医护人员中 HA-MRSA 的流行率为 13.8%。尽管 CA-MRSA 流行率较高，但这些菌株大多敏感。
因此有必要采取普遍的洗手、个人卫生和环境卫生措施。
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