Nasal carriage of multiresistant Staphylococcus aureus among health care workers and pediatric patients in two hospitals in Mogadishu, Somalia

Objectives: To study the nasal carriage rate of Staphylococcus aureus and staphylococcal susceptibility patterns among patients and health care workers in two pediatric hospitals in Mogadishu, Somalia. Methods: Nasal carriage was detected in 21 of 46 (46%) pediatric patients and in 17 of 99 (17%) of the health care workers attending these patients. Most (84%) S. aureus strains appeared to be multiresistant, especially toward those antimicrobials that were used most frequently in both clinical settings, Methicillin resistance was detected in 10 of 38 S. aureus strains. In only one of these strains was the mecA gene detected by polymerase chain reaction (PCR). The other strains were resistant because of hyperproduction of beta- lactamases. Molecular typing by arbitrary primed PCR of the S. aureus isolates revealed extensive heterogeneity among strains. The single 'genuine' methicillin resistant S, aureus (MRSA) strain was shown to be unique, whereas for the other methicillin-resistant isolates only distant relations could be demonstrated. Results: No clear evidence of extensive nosocomial spread of S. aureus strains between patients and personnel was obtained. Conclusion: Policies for antibiotic use should be revised to slow the development of resistance in S. aureus strains in the hospitals under investigation.