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Updated: Feb 4, 2026

Development and Assessment of Intracellular Infection Models for Staphylococcus aureus
Published on: January 17, 2025
Vancomycin resistance among Staphylococcus aureus isolates in a rural setting, Egypt
Nada ElSayed1, Medhat Ashour2, Amira Ezzat Khamis Amine3
1MS Microbiology Department, High Institute of Public Health, Alexandria University, 169 ElHoryah Avenue, Egypt.
Introduction:
With the increased occurrence of methicillin resistant S. aureus (MRSA), the consumption of vancomycin, the drug of choice, has also increased. As a consequence, strains of S. aureus resistant to vancomycin have started to emerge. This study aimed to evaluate the level of vancomycin resistance among clinical and nasal S. aureus isolates in a rural town in Egypt.
Methods:
This cross-sectional study was held in the general hospital at the rural town of Kafr Eldawar in Egypt, during the period from January 2013 to January 2014. S. aureus isolates were collected from clinical samples and from nasal swabs.
Results:
Two hundred S. aureus isolates were collected, 80 (40%) from clinical samples and 120 (60%) from nasal carriage samples. Vancomycin resistant S. aureus (VRSA) was only detected in clinical samples, all collected from the outpatient clinic. Eleven VRSA isolates (13.8% of total S. aureus clinical isolates) and one strain of vancomycin-intermediate S. aureus (from nasal carriage) were detected. VRSA isolates were most resistant to ciprofloxacin (90.9%) and erythromycin (81.8%). Five isolates were resistant to all tested antibiotics: ciprofloxacin, clindamycin, erythromycin, linezolid, oxacillin, penicillin and trimethoprim-sulfamethoxazole. MRSA was found to constitute 43.8% of clinical S. aureus isolates. The MRSA colonization rate among community individuals was 43.6%, 42.9% among healthcare workers and 51.4% among patients.
Conclusion:
The prevalence of VRSA was high in clinical samples suggesting that there is a high level of VRSA strains in Egypt that goes undetected since most laboratories only use disk diffusion for detection of vancomycin resistance.
Insights
Vancomycin-resistant S. aureus (VRSA) is a growing concern, with a high prevalence found in clinical samples in Egypt. This highlights a potential underdetection issue, as standard laboratory methods may not identify VRSA effectively.
Area of Science:
- Clinical microbiology
- Infectious diseases
- Antimicrobial resistance
Background:
- Rising incidence of methicillin-resistant S. aureus (MRSA) has led to increased vancomycin use.
- Emergence of vancomycin-resistant S. aureus (VRSA) poses a significant public health threat.
- Limited data exists on VRSA prevalence in rural Egyptian settings.
Purpose of the Study:
- To determine the prevalence of vancomycin resistance in clinical and nasal S. aureus isolates.
- To assess the level of vancomycin resistance in S. aureus from a rural Egyptian community.
Main Methods:
- A cross-sectional study was conducted in Kafr Eldawar, Egypt, from January 2013 to January 2014.
- S. aureus isolates were collected from clinical samples (n=80) and nasal swabs (n=120).
- Antibiotic susceptibility testing was performed, including for vancomycin resistance.
Main Results:
- Eleven VRSA isolates (13.8%) were identified exclusively in clinical samples from outpatients.
- One vancomycin-intermediate S. aureus isolate was found in nasal carriage.
- VRSA isolates showed high resistance to ciprofloxacin (90.9%) and erythromycin (81.8%); 5 isolates were multidrug-resistant.
Conclusions:
- The high prevalence of VRSA in clinical samples suggests significant underdetection in Egypt.
- Current standard laboratory methods, like disk diffusion, may not adequately detect VRSA.
- Urgent need for improved diagnostic strategies to identify VRSA strains is indicated.
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