Carriage of Staphylococcus aureus among Hajj pilgrims

OBJECTIVE: To evaluate the prevalence of methicillin resistant Staphylococcus aureus (MRSA) carriage among a cohort of pilgrims during 2004 Hajj season.

METHODS: Pilgrims attending the 2004 Hajj season were recruited and screened for carriage of MRSA. Standard microbiological techniques were used to screen for the presence of MRSA.

RESULTS: Out of 411 individuals screened, 85 (20.6%) were positive for Staphylococcus aureus (S. aureus) of which only 6 (1.46 %) were MRSA. Four individuals (4.6%) had the S. aureus organism in both nasal and axillary swabs, while 7 individuals (8%) had the organism in their axillae only. The other 74 individuals (87.1%) had the organism in their nares only. The 6 MRSA isolates were positive for the mecA gene by polymerase chain reaction method. None of the pilgrims examined had any risk factors for community-acquired methicillin resistant S. aureus (CAMRSA). Overall, the prevalence of MRSA in the population of pilgrims examined was found to be low (1.46%) in comparison with most community based studies.

CONCLUSION: A low rate of MRSA carriage was noticed among the screened cohort. Physicians treating patients suspected of S. aureus infection during the Hajj pilgrimage should bear in mind the possibility of community acquired - MRSA and should obtain appropriate samples for bacterial cultures and susceptibility testing so that antimicrobial agents could be introduced when necessary at a later stage.