Methicillin and vancomycin resistance staphylococcus aureus nasal carriage rate and antimicrobial susceptibility pattern among health care workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia

Methicillin and vancomycin resistance staphylococcus aureus nasal carriage rate and antimicrobial susceptibility pattern among health care workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Methicillin and vancomycin resistance staphylococcus aureus nasal carriage rate and antimicrobial susceptibility pattern among health care workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia Sara Tesfaye, Shamil Barsenga, Surafel Mekuria, Addisu Tesfaye, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8252559/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background healthcare workers who carry methicillin-resistant and vancomycin-resistant staphylococcus aureus pathogens in their nasal passage serves as a significant reservoir for the transmission of these resistant pathogens to patients, especially those with weakened immune systems. In Ethiopia, particularly in the study area, there is a lack of sufficient data on the prevalence of MRSA and VRSA among healthcare personnel. Therefore, this study was designed to investigate the rate of nasal carriage of methicillin- and vancomycin-resistant Staphylococcus aureus among healthcare workers. Objective This study aimed to assess the nasal carriage rate of methicillin-resistant and vancomycin-resistant staphylococcus aureus , as well as their antibiotic susceptibility pattern among healthcare workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia Materials and Methods A hospital-based cross-sectional study was carried out at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital over a three-month period, from May to July 2024. A total of 178 healthcare professionals working in various wards were enrolled using a convenient sampling method. Nasal swab samples were collected and cultured on Blood Agar and Mannitol Salt Agar, followed by incubation at 37°C for 24 hours. Bacterial identification and antimicrobial susceptibility testing were performed using the automated VITEK 2 Compact system. Result The nasal carriage rate of staphylococcus aureus and methicillin resistance staphylococcus aureus among health care workers was 21.9% (95% CI: 18.3–27.7%) and 71.8% (95%CI: 65.1–75.1%), respectively. Five (17.9%) inducible clindamycin resistance and two (5.1%) vancomycin resistance staphylococcus aureus isolates were also detected. Linezolid, Tigecycline, Vancomycin and Teicoplanin were the most effective antibiotic for both methicillin sensitive and methicillin resistance staphylococcus aureus . The overall prevalence of muti-drug resistance isolates was 41.3% (95% CI: 35.7–46.3%). Conclusions and recommendations: The high rate of methicillin resistance staphylococcus aureus carriage among health care workers is concerning and highlights the need for a further, more comprehensive study. Implementing regular screening of health care personnel is crucial to effectively control and prevent the spread of methicillin resistance staphylococcus aureus MRSA VRSA Nasal carriage Healthcare workers JJUSHYCSH Figures Figure 1 Figure 2 Introduction Staphylococcus aureus(S.aureus ) is a gram positive, non-motile, non-spore former bacteria most healthy people have on their skin and nasal mucosa (1, 2). However it is an important opportunistic human pathogen and frequent cause of both nosocomial and community acquired infections associated with high mortality and morbidity around the world (3). Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of S. aureus that has developed resistance to β-lactam antibiotics such as Methicillin, Oxacillin, Cefoxitin and Nafcillin(4). MRSA develops resistance through the acquisition of the mec A gene, which alters pencillin-binding protein, while VRSA gains resistance via the vanA gene, often acquired from vancomycin-resistance enterococci (VRE) (5). The emergence of MRSA is an important hospital acquired pathogen continues to remain a significant factor for failure of patient management worldwide (6). Methicillin resistant staphylococcus aureus (MRSA) and vancomycin resistant staphylococcus aureus (VRSA) represent significant public health threats due to their ability to cause a wide range of infections, from minor skin and soft tissue infections to severe conditions such as bloodstream infections, pneumonia, and endocarditis that are difficult to treat with standard antibiotics (7, 8). These drug resistant bacteria are associated with increased morbidity, mortality, and healthcare costs, as they require alternative, often more toxic and expensive treatment (9, 10). The problem of MRSA is observed all over the world, although, the burden of infection is high in developing countries including Africa(11). The resistance of MRSA and VRSA to standard antibiotics often necessitates the use of newer or less commonly used antibiotics, such as linezolid, daptomycin or ceftaroline, which may be expensive or have side effects. This growing prevalence of MRSA and VRSA underscores the urgent need for improved infection control measures, more effective antimicrobial stewardship, and the development of novel therapies to combat these formidable pathogens. Health care workers (HCWs) play a significant role in MRSA transmission at health care institutions. Colonized HCWs have been implicated as a source of infection for their patients and themselves as they propagate it to different site of infection through their hands (12). Health care workers who have direct contact between the community and hospital may serve as the agents of the cross-transmission of the community acquired and hospital acquired MRSA (13). Therefore, the colonization of health-care workers with S. aureus , especially MRSA, is considered one of the important risk factors for nosocomial infection (14, 15). Multidrug resistance of nasal S. aureus associated with methicillin-resistant strains is of great public health concern, especially in developing countries (16, 17). Accurate and early determination of methicillin resistance is very important in the prognosis of infections (18). However, there is limited information regarding the prevalence of S. aureus and MRSA nasal colonization among health-care workers. Thus, this study aimed to determine the prevalence and antimicrobial susceptibility patterns of methicillin resistance S. aureus among health-care workers working at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga Ethiopia. Materials and Methods Study design, period, and area This hospital-based cross-sectional study was conducted from May 1 to July 30, 2024, at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital. The hospital is one of the largest tertiary-level referral and teaching hospital in the Somali region, located 630 km from Addis Ababa in eastern Ethiopia. The hospital provides surgical, orthopedic, medical, pediatric, gynecological, obstetric, ENT, neurology, dialysis and intensive care services. It has a separate laboratory units with more than 282 beds and services for people in the surrounding zones and nearby regions(19). Study populations, sample size, and sampling technique The study population consisted of health care workers working at Jigjiga University Sheik Hassan Yebare Comprehensive Specialized Hospital. Participants who had received antibiotics therapy 2weeks prior to the study and individuals who had nasal bleeding were excluded from the study. The minimum sample size was calculated based on the assumption of 5% expected margin of error and 95% confidence interval, taking the prevalence of 12.0% from the previous study that was conducted in Adigrat town (11) using a single population proportion formula and adding a 10% non-response rate, the final sample size was 178 study participants. Health care workers were stratified based on their profession and the sample size was allocated for each stratum by using convenience sampling technique. Data collection and analysis A one-day training session was conducted for the data collector, focusing on data collection procedures and interview techniques. Sociodemographic information of the participants was obtained through face-to-face interviews using semi-structured questionnaires. Sample collection, Transportation and processing Sample collection was performed according to the WHO standard for diagnosis of S. aureus . A sterile cotton swab moistened with normal saline will be passed into the anterior nares of both nostrils of study participants and rotated in both directions to obtain nasal swabs for culture. Each sample was properly labeled with a unique code number, along with the date and time of collection. The samples were then immediately placed in Amies transport medium (Oxoid, England) and transported to the Microbiology Laboratory at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital (JJUSHYCSH), where they were processed for microbiological analysis within two hours of collection. Isolation of Staphylococcus aureus and Antimicrobial susceptibility test Collected swabs were inoculated onto Mannitol Salt Agar (MSA) (Oxoid Ltd. England) to confirm the fermentation of Mannitol, the growth of golden yellow colonies on MSA surrounded by yellow zones after 24 hours of incubation at 37°C indicated a positive result for S. aureus . These isolates were sub-cultured onto Blood Agar Plate and incubated at 37°C for 24hrs for identification of type of hemolysis. Preliminary gram stain was performed and all gram positive isolates that had beta hemolytic colony on BAP, cluster appearance on the microscope and ferment mannitol (golden yellow colonies) on MSA were identified using an automated Vitek 2 compact system. The VITEK 2 system detects metabolic changes by fluorescence-based techniques which facilitate the identification of most aerobic gram-positive and gram-negative organisms. It uses small plastic cards containing multiple wells filled with either biochemical substrates or antibiotic dilutions(20). The system uses a manual filler sealer to inoculate the cards with the organism. Once these steps are complete, the VITEK 2 seals the cards into a chamber to prevent contamination during processing. The cards are then loaded into the reader incubator, which ejects them at the end of testing. The VITEK 2 uses colorimetric technology with three wavelengths of light to provide broad profiles for the most clinically significant organisms. The analysis is performed by using algorithms to look at a variety of parameters and test conditions to ensure accurate results and early detection of resistance mechanisms through proprietary software. It monitors kinetics of bacterial growth and calculates MICs using a unique algorithm (21). Each bacterial isolate was suspended in 3 milliliters of 0.45% physiological saline solution to the density of 0.5 to 0.60 McFarland measurement using DensiCHEK Plus instrument (Biomerieux, USA).The suspensions were used for both bacterial identification and AST using the Vitek 2 compact system (Biomerieux, USA) according to the manufacturer’s instructions (Biomerieux, USA). All AST inoculum dilutions, card sealing and incubator loading functions were performed by the instrument. Gram positive (GP) cards were used for Gram-positive bacterial identification. The filled and sealed cards were inserted into the Vitek 2 reader-incubation chamber and incubation was performed at temperature 35.5°C. Gram-positive AST cards were used for Gram - positive AST using Vitek-2-compact system. Optical reading of cards was performed every 15 minutes by the Vitek 2 compact system, with a multi-channeled fluorometer and photometer to record fluorescence, turbidity, and colorimetric signals. At the completion of the incubation cycle, bacterial isolates were identified, and MIC values were determined for each antibiotic contained on the card. MDR isolates were tested against different classes of antibiotics representing aminoglycosides, macrolides, cephalosporin, lincosamide, quinolones, tetracycline and sulphonamides. Multiple drug resistance is defined as the resistance of an isolate to at least one agent in three or more antimicrobial classes. Quality control All laboratory activities were conducted in accordance with standard operating procedures (SOPs). To ensure the quality and sterility of culture media, performance testing was conducted for each batch. Specifically, 5% of the prepared media were randomly selected and incubated aerobically at 37°C for 24 hours to assess sterility. The quality and performance of the media were further validated using the reference strain Staphylococcus aureus ATCC 25923. Data quality control Data quality was ensured through the use of pretested questionnaires prior to the main study to verify the feasibility and validity of the study variables. Additionally, data quality was maintained by closely monitoring the completeness of the checklists on-site by the data collectors. The principal investigator, along with the supervisor, actively oversaw the data collection process. Furthermore, the principal investigator regularly and thoroughly reviewed the collected data to ensure its completeness and clarity. Data processing and analysis Data were initially entered into EPI-Info version 7 to perform thorough checks for completeness, accuracy, and consistency. Following this, the cleaned dataset was exported to the Statistical Package for the Social Sciences (SPSS) version 20 for further statistical analysis. Descriptive statistics were computed to summarize the data, including frequencies and proportions for categorical variables, as well as means and standard deviations for continuous variables. The Chi-square test was applied to examine the association between independent variables and outcome measures. Statistical significance was determined at a p-value threshold of less than 0.05. The analyzed results were systematically organized and presented in the form of tables and figures to facilitate clear interpretation and communication. Ethical consideration Ethics clearance was obtained from the Ethics and Review Committee of the College of Medicine and Health Sciences, Jigjiga University, Ethiopia. Before data collection, the study participants were informed of the study, and their written consent for participation was obtained. For child participants, assent/consent to participate was collected from their parents/guardians in a written form, and confidentiality was maintained by omitting their names and personal identifiers throughout the study. Results Socio-demographic characteristics of the study participants A total of 178 health professionals with various types of profession were included in the study. Of the participants 92 (51.7%) were males. The ages of the participants ranged from 20 to 42 years with mean age of 31.3 ± 4.1. One hundred two (57.3%) of them were between 31 and 40 years old and 87 (48.9%) of the study participants were nurses. Majority of the study participants27 (15.2%) were from surgical department and having a service year of ≤ 5 years (51.7%) (Table 1 ). Table 1 Socio-demographic and clinical characteristics of healthcare workers at Jigjiga University Sheik HassenYebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia May to July,2024 Characteristics Category Frequency Percent Gender Male 92 51.7 Female 86 48.3 Age (years) 20–30 74 41.6 31–40 102 57.3 > 40 2 1.1 Profession Physician 39 21.9 Nurse 87 48.9 Midwife 20 11.2 Laboratory 14 7.9 Pharmacist 9 5.1 Others 9 5.1 Ward Medical 26 14.6 Surgical 27 15.2 Pediatrics 24 13.5 Neonatal ICU 18 10.1 OPD 29 16.3 Gynecology 20 11.2 Emergency 20 11.2 Laboratory 14 7.9 Service year ≤ 5 years 92 51.7 > 5 years 86 48.3 Antibiotic usage Yes 10 5.6 No 168 94.4 Prevalence of Staphylococcus aureus, MRSA and VRSA From 178 subjects who underwent nasal swab examinations the nasal carriage rate of S. aureus was 21.9% (39/178) out of which 64.1% were isolated from female participants and age group of 31–40. Most of the isolates (56.4%) were identified from nurses and 20.5% of isolates were discovered from pediatric ward. From the total of 39 S. aureus isolates 71.8% (28/39) and 5.1% (2/39) were MRSA and VRSA isolates respectively. Similarly, most of MRSA isolates (71.4%) were from female participants and 57.1% were from age group of 31–40. Like staphylococcus aureus , most of MRSA isolates (60.7%) were identified from Nurses and 25% of them were from pediatric ward. From the 39 isolates of S. aureus 7 (17.9%) were positive for inducible clindamycin resistance (Table 2 ). Table 2 Prevalence of Staphylococcus aureus , MRSA and VRSA among healthcare workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia May to July,2024 Characteristics Category S. aureus MRSA VRSA Yes No Yes No Yes No Gender Male 14(7.9%) 78(43.8%) 8(20.5%) 6(15.4%) 1(2.6%) 13(33.3%) Female 25 (14%) 61(34.3%) 20(51.3%) 5(12.8%) 1(2.6%) 24(61.5%) Age (years) 20–30 14 (7.9%) 60(33.8%) 12(30.8%) 2(5.1%) 1(2.6%) 13(33.3%) 31–40 25(14%) 77(43.2%) 16(41%) 9(23.1) 1(2.6%) 24(61.5%) > 40 0(0%) 2(1.1%) - - - - Profession Physician 8(4.5%) 31(17.4%) 4(10.3%) 4(10.3%) 1(2.6%) 7(17.9%) Nurse 22(12.4%) 65(36.5%) 17(43.5%) 5(12.8%) 0(0%) 22(56.4) Midwife 3(1.7%) 17(9.5%) 2(5.1%) 1(2.6%) 0(0%) 3(7.7%) Laboratory 3(1.7%) 11(6.2%) 2(5.1%) 1(2.6%) 0(0%) 3(7.7%) Pharmacist 3(1.7%) 6(3.4%) 3(7.7%) 0(0%) 1(2.6%) 2(5.1%) Others 0(0%) 9(5%) - - - - Ward Medical 6(3.4%) 20(11.3%) 3(7.7%) 3(7.7%) 1(2.6%) 5(12.8%) Surgical 3(1.7%) 24(13.5%) 3(7.7%) 0(0%) 0(0%) 3(7.7%) Pediatric 8(4.5%) 16(8.9%) 7(17.9%) 1(2.6%) 0(0%) 8(20.5%) Neonatal ICU 5(2.8%) 13(7.4%) 5(12.8%) 0(0%) 0(0%) 5(12.8%) OPD 7(3.9%) 22(12.4%) 5(12.8%) 2(5.1%) 0(0%) 7(17.9%) Gynecology 3(1.7%) 17(9.5%) 1(2.6%) 2(5.1%) 0(0%) 3(7.7%) Emergency 4(2.2%) 16(8.9%) 1(2.6%) 3(7.7%) 1(2.6%) 3(7.7%) Laboratory 3(1.7%) 11(6.2%) 2(5.1%) 1(2.6%) 0(0%) 3(7.7%) Service year ≤ 5 years 20(11.3%) 72(40.5%) 16(41%) 4(10.3%) 2(5.1%) 18(46.2%) > 5 years 19(10.6%) 67(37.6%) 12(30.8%) 7(17.9%) 0(0%) 19(48.7%) Antibiotic usage Yes 2(1.1%) 8(4.5%) 1(2.6%) 9(23.1%) 0(0%) 2(5.1) No 37(20.8%) 131(73.6%) 27(69.2%) 2(5.1%) 2(5.1%) 35(89.8%) Foot note: ICU = Intensive care unit, OPD = Outpatient department Antibiotic resistance patterns of Staphylococcus aureus Staphylococcus aureus showed the highest resistance to Tetracycline (48.7%), Trimethoprim/Sulfamethoxazole (43.6%), Erythromycin (43.6%) and Ciprofloxacin (35.9%). However, lowest resistance rate was observed for Tigecycline (2.6%), Linezolid (2.6%) and Vancomycin (5.6%) (Fig. 1 ). Antibiotic resistance patterns of Methicillin resistant Staphylococcus aureus Methicillin resistant Staphylococcus aureus showed the highest resistance to Tetracycline (57.1%), Erythromycin (57.1%), Ciprofloxacin (53.6%) and Trimethoprim/Sulfamethoxazole (46.4%). However, lowest resistance rate was observed for Tigecycline (3.6%), Linezolid (3.6%) and Vancomycin (7.4%) (Fig. 2 ). Multidrug resistance patterns of S.aureus and MRSA Out of 39 S. aureus isolates, 18 of them were sensetive to all antibiotics tested. However 16(41%) of isolates showed multidrug resistance. Additionally, from 28 MRSA isolates 15 (53.6%) of them showed multidrug resistance ( Table 3 ). Table 3 Multidrug resistance pattern of Staphylococcus aureus and MRSA isolates from healthcare workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia May to July, 2024 Classes of antibiotics S. aureus Classes of antibiotics MRSA R0 18 R0 8 R1( CIP) 3 R1 (CIP) 2 R1(CLI) 1 R1 (CLI) 1 R1(ERY) 1 R1(ERY) 1 R2 0 R2 (CIP,ERY) 1 R3 (CLI,ERY,CIP) 11 R3 (CLI,ERY,CIP) 4 R3 (CIP,GEN,ERY,MFX) 1 R3(GEN, CLI,CIP,ERY) 4 R4 (CLI, ERY,GEN,LNZ) 1 R4 (GEN,CIP,ERY,CLI) 2 R4 (CIP ,ERY,GEN, TEC) 2 R4 (GEN,CLI,ERY,LNZ) 3 R4 (CIP,CLI,ERY,GEN,MFX, VAN) 1 R4 (GEN,MFX,CLI,ERY) 2 R5 0 R5 0 R6 0 R6 0 R7 0 R7 0 Total MDR 16/39 (41%) Total MDR 15/28 (53.6%) Key : CIP: Ciprofloxacin; CLI: Clindamycine; ERY: Erythromycin; GEN: Gentamycin; LNZ: Lineolid; MFX: Moxifloxacine; TEC: Teicoplanin, VAN: Vancomycin; MDR: Multidrug resistance Discussion Health care facilities have been recognized as potential sources of MRSA organisms due to the close contact of patients with healthcare workers, patient care equipment and hospital environment. Moreover, there is a possibility of transmission of these organisms from patient to patient and healthcare worker to patient (22). Consequently, it is essential to identify MRSA nasal carriage among hospital HCWs, especially those employed in the critical care units. The present study determined the rate of MRSA carriage on HCW at JJUSHYCSH. In this study the prevalence of S. aureus carriage in nares was 21.9% (95% CI: 18.3–27.7%). This observation agrees with previous studies conducted in Bhubaneswar and Ghana (25.5%) (23, 24). However, this was lower than studies conducted in Gaza strip (31%) and Dessie, Ethiopia (28.8%) (25, 26). The local prevalence of MRSA, local infection control strategies and microbiological techniques can account for variations between countries and hospitals. These discrepancies may also be attributed to varying degrees of dedication to infection control practices. In this study, the prevalence of MRSA was 71.8% (95%CI: 65.1–75.1%). This finding was in agreement with study conducted in Minia City, Egypt (65.2%) (27). However, this was higher than studies that reported in a previous study conducted in Bhubaneswar, Iran and Ghana which was 7.5%, 31.3% and 8.5% respectively, (23, 24, 28). The discrepancy in the carriage rate may be due to variation in the study design, sample size and MRSA identification technique. The prevalence of VRSA in this study was 5.1% (95% CI: 2.9–7.3%). However studies conducted at Iran and Pakistan showed that none of study participants was found to be nasal carriers of VRSA (28, 29). However this finding was lower than studies conducted in Gaza strip (15.7%) and Libya (22%) (25, 30). Regarding the antimicrobial resistance pattern, in this study staphylococcus aureus shows the highest resistance to Tetracycline (48.7%), Trimethoprim/Sulfamethoxazole (43.6%), Erythromycin (43.6%), Ciprofloxacin (35.9%) and Cindamycine (30.8%). This was similar with studies done in Oman (Tetracycline (50%), Trimethoprim/Sulfamethoxazole (43%), Erythromycin (48%), Cindamycine (30.8%) (31). However, highest sensetivity was oserved in Tigecycline (97.4%), Linezolid (97.4%), Vancomycin (94.7%), and Teicopanin (92.3%). This was in agrrement with studies conducted in Oman (31) and North India (100% sensrtivity for each) (20). Also studies conduted in Somalia showed 100% sensetivity rate for Linezolid and Vancomycin (32). This could be due to the limited prescription and use of these antibiotics in the community. Like methicillin sensitive staphylococcus aureus MRSA isolates showed highest resistance to similar antibiotics except variying in percent which showed Tetracycline (57.1%), Erythromycin (57.1%), Ciprofloxacin (53.6%), Trimethoprim/Sulfamethoxazole (46.4%) and Cindamycine (39.3%) resistance rate. However, highest sensetivity was observed in Tigecycline (96.4%), Linezolid (96.4%), Vancomycin (92.6%) and Teicoplanin (89.3%) like methicillin sensitive staphylococcus aureus. In the present study, the overall proportion of MDR among Staphylococcus aureus was 41.3% (95% CI: 35.7–46.3%). Of these, 93.7% was observed on MRSA isolates. This finding is comparable with reports from Sudan which shows 95.7% MDR in MRSA isolates (33). Conclusion and recommendation The result of this study showed that 71.8% of health care workers were an MRSA carrier which is very high prevalence. The alarmingly high prevalence of MRSA carriage rate in our study area should be addressed in a larger study in the future. Consequently, infection prevention and control measures in hospitals should receive special attention and should be given to infection prevention and control strategies in the hospital, and routine screening of apparently asymptomatic Healthcare personnel is essential to preventing the spread of infection. Abbreviations AMR, antimicrobial resistance; ATCC, American Type Culture Collection; CLSI, Clinical and Laboratory Standard Institute; HCWs: Heath care workers; JJUSHYCSH: Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital; MDR: Multidrug resistance; MRSA: Methicillin resistance staphylococcus aureus ; MSSA: Methicillin sensitive staphylococcus aureus ; SPSS, Statistical Package for Social Sciences; VRSA: Vancomycin resistance staphylococcus aureus Declarations Acknowledgement First, our heartfelt gratitude goes to Jigjiga University for funding this research. Second we are indebted to Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital administration and staffs or their support. Last our appreciation goes to heath care workers for their willing of participation. Ethics approval and consent to participate Ethical clearance was obtained from Institutional Health Research Ethics Review Committee (IHRERC), Institute of Health Science, Jigjiga University (JJU-RERC 072/2024). Official support letter was written to JJUSHYCSH administration. An informed voluntary, written and signed consent was taken from participants. Study subjects were informed about the procedures and significance of the study Consent for Publication- Not applicable Availability of data and materials All data generated or analysed during this study were included in this article. Conflict of interest: The authors declare no conflict of interest. Funding: This study was funded by Jigjiga University Authors’ contributions ST, SB, and SM conceptualized the study and developed the overall study design. They were responsible for designing the data collection tools, overseeing the data analysis, interpreting the findings, and drafting the initial manuscript. ST, BT, GF, and AT played key roles in data collection, ensuring adherence to protocols, and supervising fieldwork activities. All authors—ST, BT, SB, GF, and AT—collaboratively contributed to interpreting the study results, providing critical feedback, and reviewing both the initial and final versions of the manuscript to ensure scientific accuracy and clarity. All authors have read, revised, and approved the final manuscript for publication. References Awulachew E, Diriba K, Anja A, Wudneh F. Nasopharyngeal carriage of Staphylococcus aureus and its antimicrobial resistance pattern among healthy people: Systematic review and meta-analysis. J Bacteriol Parasitol. 2020;11:383. 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Nasal Screening of Health Care Workers (Nursing staff) to Study the Prevalence of Methicillin Resistant Staphylococcus Aureus (MRSA) Carriage and its Antibiotic Sensitivity Profile in a Rural Tertiary Health Care Center. Journal of Research in Applied and Basic Medical Sciences. 2024;10(1):65-71. Joyanes P, del Carmen Conejo M, Martínez-Martínez L, Perea EJ. Evaluation of the VITEK 2 system for the identification and susceptibility testing of three species of nonfermenting gram-negative rods frequently isolated from clinical samples. J Clin Microbiol. 2001;39(9):3247-53. Jayathilaka N, Piyumali M, Weerasinghe TG, Nakkawita D, Senaratne T. Nasal Colonization of Methicillin-Resistant Staphylococcus aureus among Nurses at a Sri Lankan Hospital. South Asian Journal of Research in Microbiology. 2024;18(9):1-9. Singh N, Mohanty S, Panda SS, Sahoo S, Pattnaik D, Jena J. Methicillin resistant Staphylococcus aureus (MRSA) carriage among health care workers in a tertiary care hospital in Bhubaneswar. Int J Community Med Public Health. 2018;5(8):3276. Walana W, Bobzah BP, Kuugbee ED, Acquah S, Ezekiel VK, Yabasin IB, et al. Staphylococcus aureus nasal carriage among healthcare workers, inpatients and caretakers in the Tamale Teaching Hospital, Ghana. Scientific African. 2020;8:e00325. El Aila NA, Al Laham NA, Ayesh BM. Nasal carriage of methicillin resistant Staphylococcus aureus among health care workers at Al Shifa hospital in Gaza Strip. BMC infectious diseases. 2017;17:1-7. Shibabaw A, Abebe T, Mihret A. Antimicrobial susceptibility pattern of nasal Staphylococcus aureus among Dessie Referral Hospital health care workers, Dessie, Northeast Ethiopia. International Journal of Infectious Diseases. 2014;25:22-5. Mohamed HA, Mahmoud GF, Abdalla SM, Mandour SA, Mohamed FY. Nasal Carriage and Molecular Characterization of Methicillin-Resistant Staphylococcus aureus from Healthcare Workers and Community People in Minia City, Upper Egypt. Afro-Egyptian Journal of Infectious and Endemic Diseases. 2025;15(2):159-68. Firouzi F, Akhtari J, Nasrolahei M. Prevalence of MRSA and VRSA strains of Staphylococcus aureus in healthcare staff and inpatients. Journal of Mazandaran University of Medical Sciences. 2016;26(142):96-107. Ghumman AH, Khan WM, Ilyas U, Kanwal A, Zahoor W, Baloch AH. Methicilin-resistant aureus (MRSA) and vancomycin-resistant Staphylococcus aureus (VRSA) nasal carriage in health care personnel and medical students of tertiary healthcare units. J Rawalpindi Med Coll Stud Suppl. 2016;20:72-6. Bashir KA, Argoup AM, Ali HA, Jama HK, Jama SM, Zerbiga ME. Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) among healthcare workers in Yafran general hospital. African Journal of Advanced Pure and Applied Sciences (AJAPAS). 2024:229-34. Pathare NA, Asogan H, Tejani S, Al Mahruqi G, Al Fakhri S, Zafarulla R, et al. Prevalence of methicillin resistant Staphylococcus aureus [MRSA] colonization or carriage among health-care workers. Journal of Infection and Public Health. 2016;9(5):571-6. Aweis ADH, Ga’al H, Ishaq Aweis DM, Hassan GD. Nasal carriage of methicillin-resistant Staphylococcus aureus in healthcare workers at Banadir Hospital, Mogadishu, Somalia. Frontiers in Tropical Diseases. 2025;6:1425042. Mohemd AAA, Ahmed GAA, Salama A. Prevalence of Methicillin Resistant Staphylococcus Aureus Among Healthcare Workers in El-Obied City, Sudan. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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1","display":"","copyAsset":false,"role":"figure","size":52719,"visible":true,"origin":"","legend":"\u003cp\u003eAntibiotic susceptibility patterns of S. aureus among healthcare workers at JJUSHYCSH\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8252559/v1/5711bdce2185304925903b78.jpg"},{"id":97270613,"identity":"d731bf81-cee4-4b62-8044-444a4f0b12fd","added_by":"auto","created_at":"2025-12-02 14:56:55","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":51036,"visible":true,"origin":"","legend":"\u003cp\u003eAntibiotic susceptibility patterns of MRSA among healthcare workers at JJUSHYCSH\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8252559/v1/2134f5aba87b083c2cd57ed4.jpg"},{"id":98622181,"identity":"0fec05df-e2eb-47d9-9118-5c9814cd3ec1","added_by":"auto","created_at":"2025-12-19 16:48:00","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1174207,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8252559/v1/216eec13-ca8c-4381-8359-c6a2f6aa3a17.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Methicillin and vancomycin resistance staphylococcus aureus nasal carriage rate and antimicrobial susceptibility pattern among health care workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia","fulltext":[{"header":"Introduction","content":"\u003cp\u003e\u003cem\u003eStaphylococcus aureus(S.aureus\u003c/em\u003e) is a gram positive, non-motile, non-spore former bacteria most healthy people have on their skin and nasal mucosa (1, 2). However it is an important opportunistic human pathogen and frequent cause of both nosocomial and community acquired infections associated with high mortality and morbidity around the world (3).\u003c/p\u003e\u003cp\u003eMethicillin-resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e(MRSA) is a strain of \u003cem\u003eS. aureus\u003c/em\u003e that has developed resistance to β-lactam antibiotics such as Methicillin, Oxacillin, Cefoxitin and Nafcillin(4). MRSA develops resistance through the acquisition of the \u003cem\u003emec\u003c/em\u003eA gene, which alters pencillin-binding protein, while VRSA gains resistance via the vanA gene, often acquired from vancomycin-resistance enterococci (VRE) (5). The emergence of MRSA is an important hospital acquired pathogen continues to remain a significant factor for failure of patient management worldwide (6).\u003c/p\u003e\u003cp\u003eMethicillin \u003cem\u003eresistant staphylococcus aureus\u003c/em\u003e (MRSA) and vancomycin resistant \u003cem\u003estaphylococcus aureus\u003c/em\u003e (VRSA) represent significant public health threats due to their ability to cause a wide range of infections, from minor skin and soft tissue infections to severe conditions such as bloodstream infections, pneumonia, and endocarditis that are difficult to treat with standard antibiotics (7, 8). These drug resistant bacteria are associated with increased morbidity, mortality, and healthcare costs, as they require alternative, often more toxic and expensive treatment (9, 10).\u003c/p\u003e\u003cp\u003eThe problem of MRSA is observed all over the world, although, the burden of infection is high in developing countries including Africa(11). The resistance of MRSA and VRSA to standard antibiotics often necessitates the use of newer or less commonly used antibiotics, such as linezolid, daptomycin or ceftaroline, which may be expensive or have side effects. This growing prevalence of MRSA and VRSA underscores the urgent need for improved infection control measures, more effective antimicrobial stewardship, and the development of novel therapies to combat these formidable pathogens.\u003c/p\u003e\u003cp\u003eHealth care workers (HCWs) play a significant role in MRSA transmission at health care institutions. Colonized HCWs have been implicated as a source of infection for their patients and themselves as they propagate it to different site of infection through their hands (12). Health care workers who have direct contact between the community and hospital may serve as the agents of the cross-transmission of the community acquired and hospital acquired MRSA (13).\u003c/p\u003e\u003cp\u003eTherefore, the colonization of health-care workers with \u003cem\u003eS. aureus\u003c/em\u003e, especially MRSA, is considered one of the important risk factors for nosocomial infection (14, 15). Multidrug resistance of nasal \u003cem\u003eS. aureus\u003c/em\u003e associated with methicillin-resistant strains is of great public health concern, especially in developing countries (16, 17). Accurate and early determination of methicillin resistance is very important in the prognosis of infections (18).\u003c/p\u003e\u003cp\u003eHowever, there is limited information regarding the prevalence of \u003cem\u003eS. aureus\u003c/em\u003e and MRSA nasal colonization among health-care workers. Thus, this study aimed to determine the prevalence and antimicrobial susceptibility patterns of methicillin resistance \u003cem\u003eS. aureus\u003c/em\u003e among health-care workers working at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga Ethiopia.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy design, period, and area\u003c/h2\u003e\u003cp\u003eThis hospital-based cross-sectional study was conducted from May 1 to July 30, 2024, at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital. The hospital is one of the largest tertiary-level referral and teaching hospital in the Somali region, located 630 km from Addis Ababa in eastern Ethiopia. The hospital provides surgical, orthopedic, medical, pediatric, gynecological, obstetric, ENT, neurology, dialysis and intensive care services. It has a separate laboratory units with more than 282 beds and services for people in the surrounding zones and nearby regions(19).\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eStudy populations, sample size, and sampling technique\u003c/h3\u003e\n\u003cp\u003eThe study population consisted of health care workers working at Jigjiga University Sheik Hassan Yebare Comprehensive Specialized Hospital. Participants who had received antibiotics therapy 2weeks prior to the study and individuals who had nasal bleeding were excluded from the study. The minimum sample size was calculated based on the assumption of 5% expected margin of error and 95% confidence interval, taking the prevalence of 12.0% from the previous study that was conducted in Adigrat town (11) using a single population proportion formula and adding a 10% non-response rate, the final sample size was 178 study participants. Health care workers were stratified based on their profession and the sample size was allocated for each stratum by using convenience sampling technique.\u003c/p\u003e\n\u003ch3\u003eData collection and analysis\u003c/h3\u003e\n\u003cp\u003eA one-day training session was conducted for the data collector, focusing on data collection procedures and interview techniques. Sociodemographic information of the participants was obtained through face-to-face interviews using semi-structured questionnaires.\u003c/p\u003e\n\u003ch3\u003eSample collection, Transportation and processing\u003c/h3\u003e\n\u003cp\u003eSample collection was performed according to the WHO standard for diagnosis of \u003cem\u003eS. aureus\u003c/em\u003e. A sterile cotton swab moistened with normal saline will be passed into the anterior nares of both nostrils of study participants and rotated in both directions to obtain nasal swabs for culture. Each sample was properly labeled with a unique code number, along with the date and time of collection. The samples were then immediately placed in Amies transport medium (Oxoid, England) and transported to the Microbiology Laboratory at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital (JJUSHYCSH), where they were processed for microbiological analysis within two hours of collection.\u003c/p\u003e\n\u003ch3\u003eIsolation of Staphylococcus aureus and Antimicrobial susceptibility test\u003c/h3\u003e\n\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eCollected swabs were inoculated onto Mannitol Salt Agar (MSA) (Oxoid Ltd. England) to confirm the fermentation of Mannitol, the growth of golden yellow colonies on MSA surrounded by yellow zones after 24 hours of incubation at 37°C indicated a positive result for \u003cem\u003eS. aureus\u003c/em\u003e. These isolates were sub-cultured onto Blood Agar Plate and incubated at 37°C for 24hrs for identification of type of hemolysis. Preliminary gram stain was performed and all gram positive isolates that had beta hemolytic colony on BAP, cluster appearance on the microscope and ferment mannitol (golden yellow colonies) on MSA were identified using an automated Vitek 2 compact system.\u003c/p\u003e\u003cp\u003eThe VITEK 2 system detects metabolic changes by fluorescence-based techniques which facilitate the identification of most aerobic gram-positive and gram-negative organisms. It uses small plastic cards containing multiple wells filled with either biochemical substrates or antibiotic dilutions(20). The system uses a manual filler sealer to inoculate the cards with the organism. Once these steps are complete, the VITEK 2 seals the cards into a chamber to prevent contamination during processing. The cards are then loaded into the reader incubator, which ejects them at the end of testing. The VITEK 2 uses colorimetric technology with three wavelengths of light to provide broad profiles for the most clinically significant organisms. The analysis is performed by using algorithms to look at a variety of parameters and test conditions to ensure accurate results and early detection of resistance mechanisms through proprietary software. It monitors kinetics of bacterial growth and calculates MICs using a unique algorithm (21).\u003c/p\u003e\u003cp\u003eEach bacterial isolate was suspended in 3 milliliters of 0.45% physiological saline solution to the density of 0.5 to 0.60 McFarland measurement using DensiCHEK Plus instrument (Biomerieux, USA).The suspensions were used for both bacterial identification and AST using the Vitek 2 compact system (Biomerieux, USA) according to the manufacturer’s instructions (Biomerieux, USA). All AST inoculum dilutions, card sealing and incubator loading functions were performed by the instrument.\u003c/p\u003e\u003cp\u003eGram positive (GP) cards were used for Gram-positive bacterial identification. The filled and sealed cards were inserted into the Vitek 2 reader-incubation chamber and incubation was performed at temperature 35.5°C. Gram-positive AST cards were used for Gram - positive AST using Vitek-2-compact system. Optical reading of cards was performed every 15 minutes by the Vitek 2 compact system, with a multi-channeled fluorometer and photometer to record fluorescence, turbidity, and colorimetric signals.\u003c/p\u003e\u003cp\u003eAt the completion of the incubation cycle, bacterial isolates were identified, and MIC values were determined for each antibiotic contained on the card. MDR isolates were tested against different classes of antibiotics representing aminoglycosides, macrolides, cephalosporin, lincosamide, quinolones, tetracycline and sulphonamides. Multiple drug resistance is defined as the resistance of an isolate to at least one agent in three or more antimicrobial classes.\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eQuality control\u003c/h2\u003e\u003cp\u003eAll laboratory activities were conducted in accordance with standard operating procedures (SOPs). To ensure the quality and sterility of culture media, performance testing was conducted for each batch. Specifically, 5% of the prepared media were randomly selected and incubated aerobically at 37°C for 24 hours to assess sterility. The quality and performance of the media were further validated using the reference strain \u003cem\u003eStaphylococcus aureus\u003c/em\u003e ATCC 25923.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eData quality control\u003c/h3\u003e\n\u003cp\u003eData quality was ensured through the use of pretested questionnaires prior to the main study to verify the feasibility and validity of the study variables. Additionally, data quality was maintained by closely monitoring the completeness of the checklists on-site by the data collectors. The principal investigator, along with the supervisor, actively oversaw the data collection process. Furthermore, the principal investigator regularly and thoroughly reviewed the collected data to ensure its completeness and clarity.\u003c/p\u003e\n\u003ch3\u003eData processing and analysis\u003c/h3\u003e\n\u003cp\u003eData were initially entered into EPI-Info version 7 to perform thorough checks for completeness, accuracy, and consistency. Following this, the cleaned dataset was exported to the Statistical Package for the Social Sciences (SPSS) version 20 for further statistical analysis. Descriptive statistics were computed to summarize the data, including frequencies and proportions for categorical variables, as well as means and standard deviations for continuous variables. The Chi-square test was applied to examine the association between independent variables and outcome measures. Statistical significance was determined at a p-value threshold of less than 0.05. The analyzed results were systematically organized and presented in the form of tables and figures to facilitate clear interpretation and communication.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eEthical consideration\u003c/h2\u003e\u003cp\u003e Ethics clearance was obtained from the Ethics and Review Committee of the College of Medicine and Health Sciences, Jigjiga University, Ethiopia. Before data collection, the study participants were informed of the study, and their written consent for participation was obtained. For child participants, assent/consent to participate was collected from their parents/guardians in a written form, and confidentiality was maintained by omitting their names and personal identifiers throughout the study.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003ch2\u003eSocio-demographic characteristics of the study participants\u003c/h2\u003e\u003cp\u003eA total of 178 health professionals with various types of profession were included in the study. Of the participants 92 (51.7%) were males. The ages of the participants ranged from 20 to 42 years with mean age of 31.3 ± 4.1. One hundred two (57.3%) of them were between 31 and 40 years old and 87 (48.9%) of the study participants were nurses. Majority of the study participants27 (15.2%) were from surgical department and having a service year of ≤ 5 years (51.7%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSocio-demographic and clinical characteristics of healthcare workers at Jigjiga University Sheik HassenYebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia May to July,2024\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e51.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e48.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20–30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e41.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31–40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e102\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e57.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt; 40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003eProfession\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhysician\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e21.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e48.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMidwife\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLaboratory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePharmacist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e\u003cp\u003eWard\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedical\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSurgical\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e15.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePediatrics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNeonatal ICU\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOPD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGynecology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmergency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLaboratory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eService year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e≤ 5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e51.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt; 5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e48.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAntibiotic usage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e168\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e94.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003ch2\u003ePrevalence of Staphylococcus aureus, MRSA and VRSA\u003c/h2\u003e\u003cp\u003eFrom 178 subjects who underwent nasal swab examinations the nasal carriage rate of \u003cem\u003eS. aureus\u003c/em\u003e was 21.9% (39/178) out of which 64.1% were isolated from female participants and age group of 31–40. Most of the isolates (56.4%) were identified from nurses and 20.5% of isolates were discovered from pediatric ward. From the total of 39 \u003cem\u003eS. aureus\u003c/em\u003e isolates 71.8% (28/39) and 5.1% (2/39) were MRSA and VRSA isolates respectively. Similarly, most of MRSA isolates (71.4%) were from female participants and 57.1% were from age group of 31–40. Like \u003cem\u003estaphylococcus aureus\u003c/em\u003e, most of MRSA isolates (60.7%) were identified from Nurses and 25% of them were from pediatric ward. From the 39 isolates of \u003cem\u003eS. aureus\u003c/em\u003e 7 (17.9%) were positive for inducible clindamycin resistance (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePrevalence of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e, MRSA and VRSA among healthcare workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia May to July,2024\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003c/colgroup\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eS. aureus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eMRSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003eVRSA\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14(7.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e78(43.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8(20.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6(15.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e13(33.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25 (14%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61(34.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20(51.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5(12.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e24(61.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20–30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (7.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60(33.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12(30.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2(5.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e13(33.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31–40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25(14%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e77(43.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e16(41%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9(23.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e24(61.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt; 40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2(1.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003eProfession\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhysician\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8(4.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31(17.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4(10.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4(10.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e7(17.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22(12.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e65(36.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17(43.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5(12.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e22(56.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMidwife\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(1.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(9.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2(5.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLaboratory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(1.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(6.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2(5.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePharmacist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(1.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6(3.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e2(5.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9(5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e\u003cp\u003eWard\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedical\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(3.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20(11.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e5(12.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSurgical\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(1.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24(13.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePediatric\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8(4.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16(8.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7(17.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e8(20.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNeonatal ICU\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5(2.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13(7.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5(12.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e5(12.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOPD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7(3.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22(12.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5(12.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2(5.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e7(17.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGynecology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(1.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(9.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2(5.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmergency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4(2.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16(8.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLaboratory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(1.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(6.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2(5.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3(7.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eService year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e≤ 5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20(11.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e72(40.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e16(41%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4(10.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2(5.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e18(46.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt; 5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19(10.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e67(37.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12(30.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7(17.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e19(48.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAntibiotic usage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2(1.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8(4.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1(2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9(23.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e2(5.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37(20.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e131(73.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e27(69.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2(5.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2(5.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e35(89.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eFoot note: ICU = Intensive care unit, OPD = Outpatient department\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003ch2\u003eAntibiotic resistance patterns of Staphylococcus aureus\u003c/h2\u003e\u003cp\u003e\u003cem\u003eStaphylococcus aureus\u003c/em\u003e showed the highest resistance to Tetracycline (48.7%), Trimethoprim/Sulfamethoxazole (43.6%), Erythromycin (43.6%) and Ciprofloxacin (35.9%). However, lowest resistance rate was observed for Tigecycline (2.6%), Linezolid (2.6%) and Vancomycin (5.6%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003ch2\u003eAntibiotic resistance patterns of Methicillin resistant Staphylococcus aureus\u003c/h2\u003e\u003cp\u003eMethicillin resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e showed the highest resistance to Tetracycline (57.1%), Erythromycin (57.1%), Ciprofloxacin (53.6%) and Trimethoprim/Sulfamethoxazole (46.4%). However, lowest resistance rate was observed for Tigecycline (3.6%), Linezolid (3.6%) and Vancomycin (7.4%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003ch2\u003eMultidrug resistance patterns of S.aureus and MRSA\u003c/h2\u003e\u003cp\u003eOut of 39 \u003cem\u003eS. aureus\u003c/em\u003e isolates, 18 of them were sensetive to all antibiotics tested. However 16(41%) of isolates showed multidrug resistance. Additionally, from 28 MRSA isolates 15 (53.6%) of them showed multidrug resistance ( Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMultidrug resistance pattern of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e and MRSA isolates from healthcare workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia May to July, 2024\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eClasses of antibiotics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003eS. aureus\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eClasses of antibiotics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMRSA\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR1( CIP)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR1 (CIP)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR1(CLI)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR1 (CLI)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR1(ERY)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR1(ERY)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR2 (CIP,ERY)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR3 (CLI,ERY,CIP)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR3 (CLI,ERY,CIP)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR3 (CIP,GEN,ERY,MFX)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR3(GEN, CLI,CIP,ERY)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR4 (CLI, ERY,GEN,LNZ)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR4 (GEN,CIP,ERY,CLI)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR4 (CIP ,ERY,GEN, TEC)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR4 (GEN,CLI,ERY,LNZ)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR4 (CIP,CLI,ERY,GEN,MFX, VAN)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR4 (GEN,MFX,CLI,ERY)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal MDR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16/39 (41%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eTotal MDR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15/28 (53.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003eKey\u003c/b\u003e: CIP: Ciprofloxacin; CLI: Clindamycine; ERY: Erythromycin; GEN: Gentamycin; LNZ: Lineolid; MFX: Moxifloxacine; TEC: Teicoplanin, VAN: Vancomycin; MDR: Multidrug resistance\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eHealth care facilities have been recognized as potential sources of MRSA organisms due to the close contact of patients with healthcare workers, patient care equipment and hospital environment. Moreover, there is a possibility of transmission of these organisms from patient to patient and healthcare worker to patient (22). Consequently, it is essential to identify MRSA nasal carriage among hospital HCWs, especially those employed in the critical care units. The present study determined the rate of MRSA carriage on HCW at JJUSHYCSH.\u003c/p\u003e\u003cp\u003eIn this study the prevalence of \u003cem\u003eS. aureus\u003c/em\u003e carriage in nares was 21.9% (95% CI: 18.3–27.7%). This observation agrees with previous studies conducted in Bhubaneswar and Ghana (25.5%) (23, 24). However, this was lower than studies conducted in Gaza strip (31%) and Dessie, Ethiopia (28.8%) (25, 26). The local prevalence of MRSA, local infection control strategies and microbiological techniques can account for variations between countries and hospitals. These discrepancies may also be attributed to varying degrees of dedication to infection control practices.\u003c/p\u003e\u003cp\u003eIn this study, the prevalence of MRSA was 71.8% (95%CI: 65.1–75.1%). This finding was in agreement with study conducted in Minia City, Egypt (65.2%) (27). However, this was higher than studies that reported in a previous study conducted in Bhubaneswar, Iran and Ghana which was 7.5%, 31.3% and 8.5% respectively, (23, 24, 28). The discrepancy in the carriage rate may be due to variation in the study design, sample size and MRSA identification technique.\u003c/p\u003e\u003cp\u003eThe prevalence of VRSA in this study was 5.1% (95% CI: 2.9–7.3%). However studies conducted at Iran and Pakistan showed that none of study participants was found to be nasal carriers of VRSA (28, 29). However this finding was lower than studies conducted in Gaza strip (15.7%) and Libya (22%) (25, 30).\u003c/p\u003e\u003cp\u003eRegarding the antimicrobial resistance pattern, in this study \u003cem\u003estaphylococcus aureus\u003c/em\u003e shows the highest resistance to Tetracycline (48.7%), Trimethoprim/Sulfamethoxazole (43.6%), Erythromycin (43.6%), Ciprofloxacin (35.9%) and Cindamycine (30.8%). This was similar with studies done in Oman (Tetracycline (50%), Trimethoprim/Sulfamethoxazole (43%), Erythromycin (48%), Cindamycine (30.8%) (31). However, highest sensetivity was oserved in Tigecycline (97.4%), Linezolid (97.4%), Vancomycin (94.7%), and Teicopanin (92.3%). This was in agrrement with studies conducted in Oman (31) and North India (100% sensrtivity for each) (20). Also studies conduted in Somalia showed 100% sensetivity rate for Linezolid and Vancomycin (32). This could be due to the limited prescription and use of these antibiotics in the community.\u003c/p\u003e\u003cp\u003eLike methicillin sensitive \u003cem\u003estaphylococcus aureus\u003c/em\u003e MRSA isolates showed highest resistance to similar antibiotics except variying in percent which showed Tetracycline (57.1%), Erythromycin (57.1%), Ciprofloxacin (53.6%), Trimethoprim/Sulfamethoxazole (46.4%) and Cindamycine (39.3%) resistance rate. However, highest sensetivity was observed in Tigecycline (96.4%), Linezolid (96.4%), Vancomycin (92.6%) and Teicoplanin (89.3%) like methicillin sensitive \u003cem\u003estaphylococcus aureus.\u003c/em\u003e\u003c/p\u003e\u003cp\u003eIn the present study, the overall proportion of MDR among \u003cem\u003eStaphylococcus aureus\u003c/em\u003e was 41.3% (95% CI: 35.7–46.3%). Of these, 93.7% was observed on MRSA isolates. This finding is comparable with reports from Sudan which shows 95.7% MDR in MRSA isolates (33).\u003c/p\u003e"},{"header":"Conclusion and recommendation","content":"\u003cp\u003eThe result of this study showed that 71.8% of health care workers were an MRSA carrier which is very high prevalence. The alarmingly high prevalence of MRSA carriage rate in our study area should be addressed in a larger study in the future. Consequently, infection prevention and control measures in hospitals should receive special attention and should be given to infection prevention and control strategies in the hospital, and routine screening of apparently asymptomatic Healthcare personnel is essential to preventing the spread of infection.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAMR, antimicrobial resistance; ATCC, American Type Culture Collection; CLSI, Clinical and Laboratory Standard Institute; HCWs: Heath care workers; JJUSHYCSH: \u0026nbsp;Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital;\u0026nbsp;MDR: Multidrug resistance; MRSA: Methicillin resistance \u003cem\u003estaphylococcus aureus\u003c/em\u003e; MSSA: Methicillin sensitive \u003cem\u003estaphylococcus aureus\u003c/em\u003e; SPSS, Statistical Package for Social Sciences; VRSA: Vancomycin resistance \u003cem\u003estaphylococcus aureus\u003c/em\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgement\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst, our heartfelt gratitude goes to Jigjiga University for funding this research. Second we are indebted to\u0026nbsp;Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital administration and staffs or their support. Last our appreciation goes to heath care workers for their willing of participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance was obtained from Institutional Health Research Ethics Review Committee (IHRERC), Institute of Health Science, Jigjiga University (JJU-RERC 072/2024). Official support letter was written to JJUSHYCSH administration. An informed voluntary, written and signed consent was taken from participants. Study subjects were informed about the procedures and significance of the study \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication-\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analysed during this study were included in this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest:\u003c/strong\u003e The authors declare no conflict of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u0026nbsp; \u0026nbsp;This study was funded by Jigjiga University \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eST, SB, and SM conceptualized the study and developed the overall study design. They were responsible for designing the data collection tools, overseeing the data analysis, interpreting the findings, and drafting the initial manuscript. ST, BT, GF, and AT played key roles in data collection, ensuring adherence to protocols, and supervising fieldwork activities. All authors—ST, BT, SB, GF, and AT—collaboratively contributed to interpreting the study results, providing critical feedback, and reviewing both the initial and final versions of the manuscript to ensure scientific accuracy and clarity. All authors have read, revised, and approved the final manuscript for publication.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAwulachew E, Diriba K, Anja A, Wudneh F. Nasopharyngeal carriage of Staphylococcus aureus and its antimicrobial resistance pattern among healthy people: Systematic review and meta-analysis. J Bacteriol Parasitol. 2020;11:383.\u003c/li\u003e\n\u003cli\u003eTreesirichod A, Hantagool S, Prommalikit O. 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BMC research notes. 2018;11:1-6.\u003c/li\u003e\n\u003cli\u003eGiri N, Maharjan S, Thapa TB, Pokhrel S, Joshi G, Shrestha O, et al. Nasal Carriage of Methicillin‐Resistant Staphylococcus aureus among Healthcare Workers in a Tertiary Care Hospital, Kathmandu, Nepal. International Journal of Microbiology. 2021;2021(1):8825746.\u003c/li\u003e\n\u003cli\u003eAdeiza SS, Onaolapo JA, Olayinka BO. Prevalence, risk-factors, and antimicrobial susceptibility profile of methicillin-resistant Staphylococcus aureus (MRSA) obtained from nares of patients and staff of Sokoto state-owned hospitals in Nigeria. GMS Hygiene and Infection Control. 2020;15.\u003c/li\u003e\n\u003cli\u003eKhatri S, Pant ND, Bhandari R, Shrestha KL, Shrestha CD, Adhikari N, et al. Nasal carriage rate of methicillin resistant Staphylococcus aureus among health care workers at a tertiary care hospital in Kathmandu, Nepal. 2017.\u003c/li\u003e\n\u003cli\u003eSaud B, Khatri G, Amatya N, Paudel G, Shrestha V. 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Prevalence of Nasal carriage of coagulase negative staphylococci and its antimicrobial susceptibility among ICU health care workers at a tertiary care hospital of Barabanki, UP. IP International Journal of Medical Microbiology and Tropical Diseases. 2023;4(2):98-102.\u003c/li\u003e\n\u003cli\u003eYimam S, Muhye A, Hassen K, Tadesse S, Banjaw Z, Ibrahim M. Depression and Glycemic Control among Adult Type 2 Diabetic Patients: A Crossectional Study in a Comprehensive Specialized Hospital, Jigjiga, Ethiopia. 2023.\u003c/li\u003e\n\u003cli\u003eLoomba A, Grover P, Nokwal A, Arora B. Nasal Screening of Health Care Workers (Nursing staff) to Study the Prevalence of Methicillin Resistant Staphylococcus Aureus (MRSA) Carriage and its Antibiotic Sensitivity Profile in a Rural Tertiary Health Care Center. Journal of Research in Applied and Basic Medical Sciences. 2024;10(1):65-71.\u003c/li\u003e\n\u003cli\u003eJoyanes P, del Carmen Conejo M, Mart\u0026iacute;nez-Mart\u0026iacute;nez L, Perea EJ. Evaluation of the VITEK 2 system for the identification and susceptibility testing of three species of nonfermenting gram-negative rods frequently isolated from clinical samples. J Clin Microbiol. 2001;39(9):3247-53.\u003c/li\u003e\n\u003cli\u003eJayathilaka N, Piyumali M, Weerasinghe TG, Nakkawita D, Senaratne T. Nasal Colonization of Methicillin-Resistant Staphylococcus aureus among Nurses at a Sri Lankan Hospital. South Asian Journal of Research in Microbiology. 2024;18(9):1-9.\u003c/li\u003e\n\u003cli\u003eSingh N, Mohanty S, Panda SS, Sahoo S, Pattnaik D, Jena J. Methicillin resistant Staphylococcus aureus (MRSA) carriage among health care workers in a tertiary care hospital in Bhubaneswar. Int J Community Med Public Health. 2018;5(8):3276.\u003c/li\u003e\n\u003cli\u003eWalana W, Bobzah BP, Kuugbee ED, Acquah S, Ezekiel VK, Yabasin IB, et al. Staphylococcus aureus nasal carriage among healthcare workers, inpatients and caretakers in the Tamale Teaching Hospital, Ghana. Scientific African. 2020;8:e00325.\u003c/li\u003e\n\u003cli\u003eEl Aila NA, Al Laham NA, Ayesh BM. Nasal carriage of methicillin resistant Staphylococcus aureus among health care workers at Al Shifa hospital in Gaza Strip. BMC infectious diseases. 2017;17:1-7.\u003c/li\u003e\n\u003cli\u003eShibabaw A, Abebe T, Mihret A. Antimicrobial susceptibility pattern of nasal Staphylococcus aureus among Dessie Referral Hospital health care workers, Dessie, Northeast Ethiopia. International Journal of Infectious Diseases. 2014;25:22-5.\u003c/li\u003e\n\u003cli\u003eMohamed HA, Mahmoud GF, Abdalla SM, Mandour SA, Mohamed FY. Nasal Carriage and Molecular Characterization of Methicillin-Resistant Staphylococcus aureus from Healthcare Workers and Community People in Minia City, Upper Egypt. Afro-Egyptian Journal of Infectious and Endemic Diseases. 2025;15(2):159-68.\u003c/li\u003e\n\u003cli\u003eFirouzi F, Akhtari J, Nasrolahei M. Prevalence of MRSA and VRSA strains of Staphylococcus aureus in healthcare staff and inpatients. Journal of Mazandaran University of Medical Sciences. 2016;26(142):96-107.\u003c/li\u003e\n\u003cli\u003eGhumman AH, Khan WM, Ilyas U, Kanwal A, Zahoor W, Baloch AH. Methicilin-resistant aureus (MRSA) and vancomycin-resistant Staphylococcus aureus (VRSA) nasal carriage in health care personnel and medical students of tertiary healthcare units. J Rawalpindi Med Coll Stud Suppl. 2016;20:72-6.\u003c/li\u003e\n\u003cli\u003eBashir KA, Argoup AM, Ali HA, Jama HK, Jama SM, Zerbiga ME. Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) among healthcare workers in Yafran general hospital. African Journal of Advanced Pure and Applied Sciences (AJAPAS). 2024:229-34.\u003c/li\u003e\n\u003cli\u003ePathare NA, Asogan H, Tejani S, Al Mahruqi G, Al Fakhri S, Zafarulla R, et al. Prevalence of methicillin resistant Staphylococcus aureus [MRSA] colonization or carriage among health-care workers. Journal of Infection and Public Health. 2016;9(5):571-6.\u003c/li\u003e\n\u003cli\u003eAweis ADH, Ga\u0026rsquo;al H, Ishaq Aweis DM, Hassan GD. Nasal carriage of methicillin-resistant Staphylococcus aureus in healthcare workers at Banadir Hospital, Mogadishu, Somalia. Frontiers in Tropical Diseases. 2025;6:1425042.\u003c/li\u003e\n\u003cli\u003eMohemd AAA, Ahmed GAA, Salama A. Prevalence of Methicillin Resistant Staphylococcus Aureus Among Healthcare Workers in El-Obied City, Sudan.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"MRSA, VRSA, Nasal carriage, Healthcare workers, JJUSHYCSH","lastPublishedDoi":"10.21203/rs.3.rs-8252559/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8252559/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003ehealthcare workers who carry methicillin-resistant and vancomycin-resistant \u003cem\u003estaphylococcus aureus\u003c/em\u003e pathogens in their nasal passage serves as a significant reservoir for the transmission of these resistant pathogens to patients, especially those with weakened immune systems. In Ethiopia, particularly in the study area, there is a lack of sufficient data on the prevalence of MRSA and VRSA among healthcare personnel. Therefore, this study was designed to investigate the rate of nasal carriage of methicillin- and vancomycin-resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e among healthcare workers.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThis study aimed to assess the nasal carriage rate of methicillin-resistant and vancomycin-resistant \u003cem\u003estaphylococcus aureus\u003c/em\u003e, as well as their antibiotic susceptibility pattern among healthcare workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e\u003cp\u003eA hospital-based cross-sectional study was carried out at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital over a three-month period, from May to July 2024. A total of 178 healthcare professionals working in various wards were enrolled using a convenient sampling method. Nasal swab samples were collected and cultured on Blood Agar and Mannitol Salt Agar, followed by incubation at 37\u0026deg;C for 24 hours. Bacterial identification and antimicrobial susceptibility testing were performed using the automated VITEK 2 Compact system.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e\u003cp\u003eThe nasal carriage rate of \u003cem\u003estaphylococcus aureus\u003c/em\u003e and methicillin resistance \u003cem\u003estaphylococcus aureus\u003c/em\u003e among health care workers was 21.9% (95% CI: 18.3\u0026ndash;27.7%) and 71.8% (95%CI: 65.1\u0026ndash;75.1%), respectively. Five (17.9%) inducible clindamycin resistance and two (5.1%) vancomycin resistance \u003cem\u003estaphylococcus aureus\u003c/em\u003e isolates were also detected. Linezolid, Tigecycline, Vancomycin and Teicoplanin were the most effective antibiotic for both methicillin sensitive and methicillin resistance \u003cem\u003estaphylococcus aureus\u003c/em\u003e. The overall prevalence of muti-drug resistance isolates was 41.3% (95% CI: 35.7\u0026ndash;46.3%).\u003c/p\u003e\u003ch2\u003eConclusions and recommendations:\u003c/h2\u003e\u003cp\u003eThe high rate of methicillin resistance staphylococcus aureus carriage among health care workers is concerning and highlights the need for a further, more comprehensive study. Implementing regular screening of health care personnel is crucial to effectively control and prevent the spread of methicillin resistance \u003cem\u003estaphylococcus aureus\u003c/em\u003e\u003c/p\u003e","manuscriptTitle":"Methicillin and vancomycin resistance staphylococcus aureus nasal carriage rate and antimicrobial susceptibility pattern among health care workers at Jigjiga University Sheik Hassen Yebare Comprehensive Specialized Hospital, Jigjiga, Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-02 14:56:50","doi":"10.21203/rs.3.rs-8252559/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0c7121ae-679e-4b3f-ad0d-47e7598182ba","owner":[],"postedDate":"December 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-15T14:24:04+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-02 14:56:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8252559","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8252559","identity":"rs-8252559","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}