MRSA nasal carriage in Portuguese-speaking African countries (PALOP) and East-Timor
Authors: Teresa Conceição, Céline Coelho, Isabel Santos Silva, Hermínia de Lencastre, Marta Aires-de-Sousa
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Methicillin-resistant Staphylococcus aureus (MRSA) is a major human pathogen worldwide. However, MRSA prevalence in the Portuguese-speaking African countries (PALOP) and East-Timor is unknown.
Between November 2010 and July 2013, 826 inpatients and 480 healthcare workers from six hospitals located in PALOP countries (São Tomé and Príncipe, Angola and Cape Verde) and two hospitals in East Timor were nasal swabbed for MRSA carriage. Two hundred and fifty height individuals (19.8%) were S. aureus nasal carriers, out of which 86 (33.3%) were resistant to methicillin, corresponding to a global MRSA carriage rate of 6,6%. The highest MRSA prevalence was detected in Angola (13.8%), followed by São Tomé and Príncipe (4.2%) and Cape Verde (1.3%). No MRSA were found in East Timor. Methicillin resistance was higher among S. aureus isolates from Angola (58,1%) and São Tomé (26,9%) comparing to Cape Verde (6%). Moreover, the MRSA prevalence was similar between patients and healthcare workers (7.1% vs 5.6%; p=0.3), out of which the hospital cleaning staff (10.5%) showed the highest MRSA carriage rate, followed by physicians (7.4%) and nurses (6.8%). Regarding the hospital wards, higher MRSA rates were detected in Intensive Care Units (11.7%), pediatrics (6.8%) and orthopedics (6.3%).
The high MRSA rates are worrisome in some of the PALOP countries, pointing out to the need of future surveillance studies and the implementation of more strict and effective infection control measures.