Frequency of Nasal Carriage of Staphylococcus aureus and Associated Risk Factors and Its Antibiotic Susceptibility Pattern Among Healthcare Workers in Pastor and Aflatoonian Hospitals in Bam, Southeast Iran, in 2017: A Cross-Sectional Study

Colonization of Staphylococcus aureus in the nose of healthcare workers (HCWs) can be considered as the main source of nosocomial infections. The aim of this study was to investigate the frequency of S. aureus nasal carriage among HCWs in Pastor and Aflatoonian hospitals in Bam, its antibiotic resistance patterns, and determine Staphylococcal protein A (spa) typing and staphylococcal cassette chromosome mec (SCCmec) typing of methicillin resistant S. aureus isolate. In this cross-sectional study, a total of 258 nasal swabs were collected from HCWs during 2017 and were analyzed to detect methicillin sensitive and resistant S. aureus isolates. Resistance to different antibiotic agents was determined by disk diffusion. The presence of nuc, mecA, pvl genes, and spa and SCCmec types were determined  by polymerase chain reaction technique (PCR). The data were analyzed using chi-square and Fisher's exact tests. Thirty seven subjects (14.3%) were nasal carrier of S. aureus and one of them (2.7%) was resistant to methicillin with Sccmec type IV and spa type t608. All of isolates were sensitive to vancomycin, linezolid and mupirocin. The pvl gene was found in 8 (22.2%) isolates. Except with regard to gender (p=0.036), occupation, age, hospital ward, years of healthcare service, previous antibiotic therapy during the last three months, hospitalization and blood group were not significantly associated with nasal carriage (p˃ 0.05). Although according to the results, the frequency of nasal carriage of S. aureus isolates among HCWs at our hospitals compared to the other studies from Iran was low, regular S. aureus carriage screening as well as decolonization strategies is recommended.