MOLECULAR CHARACTERIZATION AND ANTIMICROBIAL SUSCEPTIBILITY OF MRSA ISOLATED FROM CHRONIC HEMODIALYSIS OUTPATIENTS AND THEIR CORRELATION TO MRSA COLONIZATION AMONG HEALTHCARE WORKERS

Abstract

The carriage of methicillin-resistant Staphylococcus aureus (MRSA) among dialysis patients is remarkable not only in terms of the risks of developing infections, but also in playing a principle part in transmission among dialysis unit staff. The aim of this study was to detect the colonization of Methicillin-sensitive Staphylococcus aureus and MRSA carriage. Also, our aim was to determine the relatedness of MRSA isolates and the potential routes of transmission using PCR- Restriction Fragment Length Polymorphism (PCR-RFLP) in Hemodialysis Unit of El Zagazig General Hospital, a tertiary medical center in Sharqia, Egypt. This study was conducted on 150 chronic hemodialysis outpatients and 200 non clinical control samples including environmental and healthcare workers (HCWs). Antibiotic susceptibility by VITEK-2 and disc diffusion, PCR amplification of mecA, pvl and coa genes and RFLP-PCR were conducted during the study period. In this study 3.3% of the patients and 3.2% of HCWs colonized with pvl positive MRSA. Fifty percent of MRSA isolates showed a single band PCR product amplification of 810bp fragment corresponding to coa gene. Ten distinct MRSA RFLP banding patterns designated as H1-H10 were obtained. The majority of strains belonged to RFLP banding pattern H1 (33.33%).The prevalence of MRSA carriage among hemodialysis patients was 14% and 9.7 % among HCWs with similar polymorphism patterns. The presence of one major coa gene type confirmed the occurrence of hospital acquired-associated MRSA.