Methicillin-resistant Staphylococcus aureus carriage rate and molecular characterization of the staphylococcal cassette chromosome mec among Syrian refugees in Iraq.

OBJECTIVES

The aim was to investigate methicillin-resistant Staphylococcus aureus (MRSA) carriage rates and to characterize the staphylococcal cassette chromosome mec (SCCmec) among Syrian refugees and the host community in Duhok, Iraq.

METHODS

A total of 492 host community and 355 Syrian refugee subjects were recruited. Participant bio-information was collected using a study questionnaire. MRSA carriage was identified as recommended in the Clinical and Laboratory Standards Institute guidelines. PCR was performed for typing the mecA gene and SCCmec groups.

RESULTS

In the host community, 76/492 (15.4%) carried MRSA, whereas 49/355 (13.8%) Syrian refugees carried MRSA (p = 0.505). Refugees were classified according to their arrival date; 36/278 (13%) existing refugees and 13/77 (16.9%) new refugee arrivals were identified as MRSA carriers (p = 0.375). Regarding the risk factors influencing MRSA spread, no association was found between MRSA prevalence and risk factors. The most common types of SCCmec in both communities were types IVa and V: 67.1% and 5.26%, and 49% and 2.04%, respectively.

CONCLUSIONS

It is inferred that the effect of MRSA in refugees on the host community will be negligible. However, the refugee carriage rate is higher than that found in Western countries, the final destination of refugees. Therefore, screening for MRSA is mandated and the rapid detection of carriers would prevent its spread.