Nasal Methicillin- Resistant staphylococcus Aurerus Carriage in East Malaysian Children

Methicillin resistant Staphylococcus aureus (MRSA) has emerged as a community strain in the past decade. From October 2012 to March 2013, a total of 947 school children from eightprimary schools in the three districts of east Malaysia, ages between 7 years to 12 years, were screened for nasal carriage of MRSA. The overall prevalence of nares carriage of MRSA and Staphylococcus aureus (MSSA) were 3.4 % and 39% respectively. The carriage rate of MRSA was higher for children living in rural area (4.1%) than in the urban area (2.3%),aged 7-9 years (4.3%) than aged 10-12 years (2.7%) and Bajau ethnicity (4.!%) than other ethnicity. All 397 isolates were susceptible to vancomycin, ciprofloxacin, and gentamicin .MRSA isolates also showed susceptibility to rifampicin and cefuroxime. Of the 17 MRSA isolates available for molecular analysis, three clones with one major clone were identified and included sequence type (ST) 30- Staphylococcal chromosomal cassette (SCCmec) IV- Panton-Valentine leukocidin (PVL) genes-positive for 10 isolates, ST239-SCCmec III-PVL-negative-spa type t037 for 2 isolates and ST45-SCCmec IV-PVL-negative-t1081 for 5 isolates. Our study is population based and different from hospital based studies School children were screened from eight schools; therefore the prevalence of MRSA in the children may not reflect the entire population of Sabah, but MRSA nasal carriage may spread in the community. Future researchers have to determine several factors of nasal colonization and the efforts must be made to detect and prevent the spread of MRSA in the population