Nasal Methicillin-Resistant Staphylococcus aureus Carriage Among Foreign Workers Recruited to Taiwan From Southeastern Asian Countries

Kuan-Hung Chen; Wen-Ching Chuang; Wang-Kin Wong; Chih-Hsien Chuang; Chih-Jung Chen; Yhu-Chering Huang

doi:10.1093/ofid/ofaa586

Nasal Methicillin-Resistant Staphylococcus aureus Carriage Among Foreign Workers Recruited to Taiwan From Southeastern Asian Countries

Open Forum Infect Dis. 2020 Dec 5;8(1):ofaa586. doi: 10.1093/ofid/ofaa586. eCollection 2021 Jan.

Authors

Kuan-Hung Chen¹, Wen-Ching Chuang¹, Wang-Kin Wong¹, Chih-Hsien Chuang², Chih-Jung Chen^{3

4}, Yhu-Chering Huang^{3

4}

Affiliations

¹ Department of Medicine, Chang Gung University, Taoyuan City, Taiwan.
² Department of Pediatrics, St. Paul's Hospital, Taoyuan, Taiwan.
³ College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁴ Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Abstract

Background: In 2012, we identified the dissemination of methicillin-resistant Staphylococcus aureus (MRSA) sequence type (ST)45 strain in 14 nursing homes in Taiwan and foreign nurse workers, a significant risk factor for MRSA carriage. We conducted this study to understand MRSA carriage and molecular characteristics among foreign workers recruited from Southeastern Asian countries.

Methods: A cross-sectional study involving a total of 1935 foreign workers-929 (arrival group) and 1006 (staying group)-from Vietnam (n = 843), Indonesia (n = 780), the Philippines (n = 239), and Thailand (n = 70) were conveniently recruited during upon-arrival and regular health examination in a regional hospital. A nasal swab was obtained from each participant for detection of MRSA.

Results: Overall, MRSA carriage rate was 2.72%, with 2.26% for arrival group and 3.18% for staying group, and 4.74% for Vietnamese, 1.28% for Indonesians, 1.26% for Filipino, and none for Thai workers. Pulsotype AK/ST45 (57%) and pulsotype AX/ST188 (14%) were the top 2 dominant clones for the arrival group, whereas pulsotype D/ST59 (41%) (an endemic community clone in Taiwan) and pulsotype AK/ST45 (19%) were predominant for the staying group. A significant decrease of pulsotype AK/ST45 from 57% to 19% (P = .007) and increase of pulsotype D/ST59 from 4.8% to 41% (P = .004) were found between the arrival and the staying groups.

Conclusions: Approximately 3% of foreign workers recruited from Southeastern Asian countries to Taiwan were colonized with MRSA, including the ST45 strain. However, the MRSA isolates from workers staying in Taiwan were mostly a locally endemic clone and genetically different from those identified from workers on arrival.

Keywords: Taiwan; carriage; foreign worker; methicillin-resistant Staphylococcus aureus; sequence type 45.