Nasal Carriage, Antimicrobial Susceptibility Profile, and Enterotoxin Genes of Staphylococcus aureus Isolated from Children with Asthma

Abstract

Asthma is a chronic respiratory disease that affects children worldwide. Increasing evidence suggests that Staphylococcus aureus contributes to the pathology of asthma. The aim of this study was to evaluate the nasal carriage, antimicrobial susceptibility profile, and presence of enterotoxin genes from S. aureus isolated from children with asthma. Nasal swab samples were collected from 158 children, including 98 children with asthma and 60 healthy controls. S. aureus isolates were identified using phenotypic methods and the presence of the nuc gene. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Polymerase chain reaction (PCR) confirmed the presence of the mecA gene and enterotoxin genes. The nuc gene was confirmed in 83 isolates, resulting in a nasal carriage of 52.5% (83/158). The nasal carriage of S. aureus was higher among asthma cases (72.4%), with a significant association of S. aureus nasal carriage observed among asthma cases (OR 0.201, 95% CI 0.063– 0.645, p = 0.007). Methicillin-resistant S. aureus (MRSA) nasal carriage was 11.4%. The S. aureus isolates showed high resistance to cefoxitin (99%) and penicillin (92%) but were sensitive to gentamicin (25%). Furthermore, 67.5% of the isolates were multi-drug resistant. The staphylococcal enterotoxin c gene (sec) was the most prevalent enterotoxin (19.7%) among cases and controls. These findings highlight the need for improved antibiotic stewardship in paediatric medicine and implementation of infection control policies.