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Methicillin-Resistant Staphylococci (MRS): Carriage and Antibiotic Resistance Patterns in College Students

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Abstract

Asymptomatic carriage of methicillin-resistant Staphylococci (MRS) may allow for the unseen dissemination of antibiotic-resistant strains through the population. This study investigates the prevalence and epidemiological risk factors that contribute to the spread of MRS in a university setting in Amman, Jordan. A cross-sectional questionnaire-based study was performed in December 2019. Five hundred and four students enrolled in the study and provided skin and nasal swabs. Swabs were then processed to isolate MRS on Mannitol Salt Agar (MSA) + 4 µg/ml oxacillin. Isolates were tested for their antibiotic susceptibility using the disc diffusion assay. Epidemiological risk assessment was performed using the Chi-square test and univariate and multivariant analysis. The percentage carriage of MRS in the 504 students was 40.4%. The carriage rate of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) from the skin and nasal areas was 13.5% and 26.9%, respectively. The percentage of male carriers was significantly higher than females, and the only identified epidemiological risk factor related to the carriage was attendance at a fitness club. All MRS isolates were resistant to oxacillin (100%), cefoxitin (45.5%), erythromycin (35.2%), gentamycin (10.2%), ciprofloxacin (12.7%), nitrofurantoin (12.2%), linezolid (7.8%), amikacin (1.47%), and Vancomycin (0.49%). 42% of MRS expressed a multiple antibiotic resistance (MAR) index above 0.2. Three isolates expressed a MAR index of 0.8. MRS has been exhibited to be present in an otherwise healthy population of students, which may then act as a reservoir for MAR strains.

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Acknowledgements

The authors acknowledge the Deanship of Scientific Research at the University of Petra for facilitating all phases of this research.

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No external funding was used for conducting this study.

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Authors and Affiliations

  1. Department of Pharmacology & Biomedical Sciences, Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, Jordan

    Suzanne M. A. Abdelmalek, Mohammad W. Qinna, Rowan Al-Ejielat & Phillip J. Collier

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  1. Suzanne M. A. Abdelmalek
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  2. Mohammad W. Qinna
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  3. Rowan Al-Ejielat
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  4. Phillip J. Collier
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Contributions

SMAA had the original idea for this work, which was completed at experimentally by MWQ under the supervision of SMAA. RAE performed statistical analysis. SMAA wrote the first draft of the paper and subsequently, PJC made an intellectual contribution to the completion of the work and all subsequent drafts of the manuscript.

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Correspondence to Suzanne M. A. Abdelmalek or Phillip J. Collier.

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The authors have no relevant financial or non-financial interests to disclose.

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Ethical approval for the study was obtained from the scientific and the ethics committees at UOP (12H-11-2019).

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Abdelmalek, S.M.A., Qinna, M.W., Al-Ejielat, R. et al. Methicillin-Resistant Staphylococci (MRS): Carriage and Antibiotic Resistance Patterns in College Students. J Community Health 47, 416–424 (2022). https://doi.org/10.1007/s10900-022-01065-9

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