Assessing the Potential for MRSA and VRSA Transmission among Food Handlers in Dhamar: A Critical Need for Intervention
DOI:
https://doi.org/10.59167/tujnas.v10i2.3013Keywords:
S. aureus, MRSA, VRSA, Nasal carriageAbstract
Scientific background: Food handlers carrying Staphylococcus aureus on their noses mainly contribute to food contamination. Antibiotic resistance in S. aureus represents a significant public health concern. The drug of choice, Vancomycin, has become more popular as the rate of MRSA has increased. Consequently, VRSA has begun to emerge. This study aimed to assess the distribution of S. aureus nasal carriage and its antibiotic susceptibility patterns among food handlers at Dhamar restaurants in Yemen. Method: A cross-sectional study was conducted in Dhamar City, Yemen, between January and February 2023, collecting nasal swabs from 100 food handlers. Standard bacteriological techniques were applied to inoculate the collected swabs on mannitol salt agar to identify and isolate S. aureus. Researchers used the Kirby-Bauer disk diffusion method to test the antimicrobial susceptibility of methicillin and Vancomycin. Results: S. aureus colonized 44 (44%) of the 100 nasal food handlers working in Dhamar, Yemeni restaurants. Among the 44 S. aureus isolates, 6 (13.6%) were resistant to Vancomycin (VRSA), and 23 (52.3%) were resistant to methicillin (MRSA). A correlation was not observed between the nasal carriage rate of S. aureus and specific food handler variables. In conclusion, the high nasal carriage of S. aureus, including MRSA and VRSA, among food handlers poses significant risks to consumers, underscoring the need for strict policies, routine screening, and effective management to ensure food safety and control resistant bacteria.
References
Pal, M., Gutama, K.P., Koliopoulos, T. (2021) Staphylococcus aureus, an important pathogen of public health and economic importance: A comprehensive review, Journal of Emerging Environmental Technologies and Health Protection 4: 17-32.
Kwiecinski, J.M., Horswill, A.R. (2020) Staphylococcus aureus bloodstream infections: pathogenesis and regulatory mechanisms, Current Opinion in Microbiology 53: 51-60.
Cheung, G.Y.C., Bae, J.S., Otto, M. (2021) Pathogenicity and virulence of Staphylococcus aureus, Virulence 12: 547-569.
Ahmad-Mansour, N., Loubet, P., Pouget, C., Dunyach-Remy, C., Sotto, A., Lavigne, J.P., Molle, V. (2021) Staphylococcus aureus Toxins: An Update on Their Pathogenic Properties and Potential Treatments, Toxins (Basel) 13: 677.
Grispoldi, L., Karama, M., Armani, A., Hadjicharalambous, C., Cenci-Goga, B.T. (2021) Staphylococcus aureus enterotoxin in food of animal origin and staphylococcal food poisoning risk assessment from farm to table, Italian Journal of Animal Science 20: 677-690.
Lv, G., Jiang, R., Zhang, H., Wang, L., Li, L., Gao, W., Zhang, H., Pei, Y., Wei, X., Dong, H., Qin, L. (2021) Molecular Characteristics of Staphylococcus aureus From Food Samples and Food Poisoning Outbreaks in Shijiazhuang, China, Frontiers in Microbiology 12: 652276.
Bencardino, D., Amagliani, G., Brandi, G. (2021) Carriage of Staphylococcus aureus among food handlers: An ongoing challenge in public health, Food Control 130: 108362.
Marques, V.F., Motta, C.C., Soares, B.D., Melo, D.A., Coelho, S.M., Coelho, I.D., Barbosa, H.S., Souza, M.M. (2017) Biofilm production and beta-lactamic resistance in Brazilian Staphylococcus aureus isolates from bovine mastitis, Brazilian Journal of Microbiology 48: 118-124.
Bush, K., Bradford, P.A. (2020) Epidemiology of β-Lactamase-Producing Pathogens, Clinical Microbiology Reviews 33: e00047-19.
Kim, T., Chong, Y.P., Park, K.H., Bang, K.M., Park, S.J., Kim, S.H., Jeong, J.Y., Lee, S.O., Choi, S.H., Woo, J.H., Kim, Y.S. (2019) Clinical and microbiological factors associated with early patient mortality from methicillin-resistant Staphylococcus aureus bacteremia, The Korean Journal of Internal Medicine 34: 184-194.
Hell, M., Bauer, J., Laimer, M. (2016) Molekulare Diagnostik von Methicillin-resistentem Staphylococcus aureus, Hautarzt 67: 6-15.
Ahmed, O.B. (2020) Prevalence of Methicillin-Resistant Staphylococcus aureus and Classical Enterotoxin Genes Among Sudanese Food Handlers, Cureus 12: e12289.
Fooladvand, S., Sarmadian, H., Habibi, D., van Belkum, A., Ghaznavi-Rad, E. (2019) High prevalence of methicillin resistant and enterotoxin gene-positive Staphylococcus aureus among nasally colonized food handlers in central Iran, European Journal of Clinical Microbiology & Infectious Diseases 38: 87-92.
Wijesekara, P.N.K., Kumbukgolla, W.W., Jayaweera, J., Rawat, D. (2017) Review on Usage of Vancomycin in Livestock and Humans: Maintaining Its Efficacy, Prevention of Resistance and Alternative Therapy, Veterinary Sciences 4: 6.
Silverman, S.M., Moses, J.E., Sharpless, K.B. (2017) Reengineering antibiotics to combat bacterial resistance: click chemistry [1, 2, 3]‐triazole vancomycin dimers with potent activity against MRSA and VRE, Chemistry–A European Journal 23: 79-83.
Wu, Q., Sabokroo, N., Wang, Y., Hashemian, M., Karamollahi, S., Kouhsari, E. (2021) Systematic review and meta-analysis of the epidemiology of vancomycin-resistance Staphylococcus aureus isolates, Antimicrobial Resistance & Infection Control 10: 101.
El-Zamkan, M.A., Mubarak, A.G., Ali, A.O. (2019) Prevalence and phylogenetic relationship among methicillin-and vancomycin-resistant Staphylococci isolated from hospital’s dairy food, food handlers, and patients, Journal of Advanced Veterinary and Animal Research 6: 463–473.
El-Shenawy, M., Tawfeek, M., El-Hosseiny, L., El-Shenawy, M., Farag, A., Baghdadi, H., Saleh, O., Ma, J., Soriano, J.M. (2014) Cross sectional study of skin carriage and enterotoxigenicity of Staphylococcus aureus among food handlers, Open Journal of Medical Microbiology 4: 16-22.
Beyene, G., Mamo, G., Kassa, T., Tasew, G., Mereta, S.T. (2019) Nasal and Hand Carriage Rate of Staphylococcus aureus among Food Handlers Working in Jimma Town, Southwest Ethiopia, Ethiopian Journal of Health Sciences 29: 605-612.
Castro, A., Santos, C., Meireles, H., Silva, J., Teixeira, P. (2016) Food handlers as potential sources of dissemination of virulent strains of Staphylococcus aureus in the community, Journal of Infection and Public Health 9: 153-60.
Mahros, M.A., Abd-Elghany, S.M., Sallam, K.I. (2021) Multidrug-, methicillin-, and vancomycin-resistant Staphylococcus aureus isolated from ready-to-eat meat sandwiches: An ongoing food and public health concern, International Journal of Food Microbiology 346: 109165.
Saber, T., Samir, M., El-Mekkawy, R.M., Ariny, E., El-Sayed, S.R., Enan, G., Abdelatif, S.H., Askora, A., Merwad, A.M.A., Tartor, Y.H. (2021) Methicillin- and Vancomycin-Resistant Staphylococcus aureus From Humans and Ready-To-Eat Meat: Characterization of Antimicrobial Resistance and Biofilm Formation Ability, Frontiers in Microbiology 12: 735494.
Al-Alousi, M., Al-Omary, T., Al-Shehari, A., Al-Alwi, A. (2010) Bacterial Contamination in Some Hospitals in Thamar, Thamar University Journal of Natural & Applied Sciences 2: 23-34.
Edrees, W.H., Anbar, A.A.M. (2021) Prevalence and antibiotic susceptibility of Streptococcus pyogenes isolated from schoolchildren in Sana’a City, Yemen, PSM Veterinary Research 6: 22-30.
Al-Aomary, N., Edrees, W., Al-Ofairi, B., Thabit, J. (2023) Nasal carriage of Staphylococcus aureus and its antibacterial susceptibility profiles among food handlers in Sana’a restaurants, Yemen, Preprints https://doi.org/10.20944/preprints202311.0495.v1.
Khatri, S., Pant, N.D., Bhandari, R., Shrestha, K.L., Shrestha, C.D., Adhikari, N., Poudel, A. (2017) Nasal Carriage Rate of Methicillin Resistant Staphylococcus aureus among Health Care Workers at a Tertiary Care Hospital in Kathmandu, Nepal, Journal of Nepal Health Research Council 15: 26-30.
Bryant, R.E., Mazza, J.A. (1989) Effect of the abscess environment on the antimicrobial activity of ciprofloxacin, The American Journal of Medicine 87: 23s-27s.
Procop, G.W., Church, D.L., Hall, G.S., Janda, W.M. (2020) Koneman's Color Atlas and Textbook of Diagnostic Microbiology, ed., Lippincott Williams & Wilkins, Philadelphia, USA, pp. 1565
Cheesbrough, M. (2005) District laboratory practice in tropical countries, part 2, ed., Cambridge University Press, Cambridge, UK, pp. 440
Alhashimi, H.M.M., Ahmed, M.M., Mustafa, J.M. (2017) Nasal carriage of enterotoxigenic Staphylococcus aureus among food handlers in Kerbala city, Karbala International Journal of Modern Science 3: 69-74.
Simsek, Z., Koruk, I., Copur, A.C., Gürses, G. (2009) Prevalence of Staphylococcus aureus and intestinal parasites among food handlers in Sanliurfa, Southeastern Anatolia, Journal of Public Health Management and Practice 15: 518-523.
Tran, N., Rybak, M.J. (2018) β-Lactam Combinations with Vancomycin Show Synergistic Activity against Vancomycin-Susceptible Staphylococcus aureus, Vancomycin-Intermediate S. aureus (VISA), and Heterogeneous VISA, Antimicrobial Agents and Chemotherapy 62: e00157-18.
Loomba, P.S., Taneja, J., Mishra, B. (2010) Methicillin and Vancomycin Resistant S. aureus in Hospitalized Patients, Journal of Global Infectious Diseases 2: 275-83.
Mandal, S.M., Ghosh, A.K., Pati, B.R. (2015) Dissemination of antibiotic resistance in methicillin-resistant Staphylococcus aureus and vancomycin-resistant S aureus strains isolated from hospital effluents, American Journal of Infection Control 43: e87-88.
Vaidya, P., Pawar, G., Krishnamurthy, N. (2015) Community acquired MRSA infections—Three recent cases and an overview of CA MRSA infections, Pediatric Infectious Disease 7: 8-12.
Yamamoto, T., Nishiyama, A., Takano, T., Yabe, S., Higuchi, W., Razvina, O., Shi, D. (2010) Community-acquired methicillin-resistant Staphylococcus aureus: community transmission, pathogenesis, and drug resistance, Journal of Infection and Chemotherapy 16: 225-254.
Otter, J.A., French, G.L. (2011) Community-associated meticillin-resistant Staphylococcus aureus strains as a cause of healthcare-associated infection, Journal of Hospital Infection 79: 189-193.
Skov, R., Christiansen, K., Dancer, S.J., Daum, R.S., Dryden, M., Huang, Y.C., Lowy, F.D. (2012) Update on the prevention and control of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA), International Journal of Antimicrobial Agents 39: 193-200.
Eid, H.M., El-Mahallawy, H.S., Mohammed, S.R., Mohammed, N.E.Y., Eidaroos, N.H. (2022) Multidrug-resistant and enterotoxigenic methicillin-resistant Staphylococcus aureus isolated from raw milk of cows at small-scale production units, Journal of Advanced Veterinary and Animal Research 9: 113-121.
Saba, C.K.S., Naa-Inour, F., Kpordze, S.W. (2022) Antibiotic resistance pattern of methicillin-resistant Staphylococcus aureus and Escherichia coli from mobile phones of healthcare workers in public hospitals in Ghana, Pan African Medical Journal 41: 259.
Oginni, I.O., Olayinka, A.A. (2022) Distribution and Antibiotics Resistance Pattern of Community-Acquired Methicillin-Resistance Staphylococcus aureus in Southwestern Nigeria, in: Donelli, G., (Ed.), Advances in Microbiology, Infectious Diseases and Public Health. Advances in Experimental Medicine and Biology, Springer, Cham, Switzerland, pp. 81-91.
Ying, H., Mahmudiono, T., Alghazali, T., Abdelbasset, W.K., Khadivar, P., Rahimi, S., Amini, A. (2022) Molecular Characterization, Virulence Determinants, and Antimicrobial Resistance Profile of Methicillin-Resistant Staphylococcus aureus in the North of Iran; a High Prevalence of ST239-SCCmec III/t037 Clone, Chemotherapy 67: 37-46.
Firouzi, F., Akhtari, J., Nasrolahei, M. (2016) Prevalence of MRSA and VRSA strains of Staphylococcus aureus in healthcare staff and inpatients, Journal of Mazandaran University of Medical Sciences 26: 96-107.
Tang, J., Hu, J., Kang, L., Deng, Z., Wu, J., Pan, J. (2015) The use of vancomycin in the treatment of adult patients with methicillin-resistant Staphylococcus aureus (MRSA) infection: a survey in a tertiary hospital in China, International Journal of Clinical and Experimental Medicine 8: 19436-19441.
Shimizu, K., Orizu, M., Kanno, H., Kitamura, S., Konishi, T., Soma, K., Nishitani, H., Noguchi, Y., Hasegawa, S., Hasegawa, H., Wada, K. (1996) Clinical studies on vancomycin in the treatment of MRSA infection, The Japanese Journal of Antibiotics 49: 782-99.
Giuliano, C., Haase, K.K., Hall, R. (2010) Use of vancomycin pharmacokinetic-pharmacodynamic properties in the treatment of MRSA infections, Expert Review of Anti-infective Therapy 8: 95-106.
ElSayed, N., Ashour, M., Amine, A.E.K. (2018) Vancomycin resistance among Staphylococcus aureus isolates in a rural setting, Egypt, Germs 8: 134-139.
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2025 Abdullah Ali Al-Alawi, Bakeel A. Radman, Osman Esmail Al-Banaa (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
From July 2025 onward, all TUJNAS publications are licensed under the Creative Commons Attribution 4.0 International (CC BY 4.0) license. This open license allows anyone to share (copy and redistribute) and adapt (remix, transform, and build upon) the work in any medium or format, for any purpose (even commercially), as long as appropriate credit is given to the original author(s) and source. This permissive framework encourages scholarly innovation, translation, and integration into wider academic outputs by removing unnecessary legal barriers. Users of TUJNAS content must provide proper attribution and indicate if any changes were made to the original work. By enabling unrestricted reuse, the CC BY 4.0 license maximizes the reach and impact of research findings while ensuring that authors receive full recognition for their work. (For complete legal details of the CC BY 4.0 license, please refer to the official Creative Commons website.)
Submissions (from July 2025 onward): By submitting a manuscript to TUJNAS for publication (Volume 10, Issue 2, 2025 and thereafter), authors confirm the following:
- Originality: The submission is original, has not been published elsewhere, and is not under consideration by another journal.
- Copyright Retention: The author(s) retain copyright of the work, but grant TUJNAS a non-exclusive right to publish, reproduce, distribute, and archive the article.
- Open Access License: Upon acceptance, the article will be published open access under the CC BY 4.0 license.
- Repository Deposit: The author(s) agree that the full text and metadata of the article may be deposited in digital archives or repositories, to facilitate indexing and reuse under the CC BY 4.0 license.
- Indexing and Sharing: The author(s) acknowledge that TUJNAS may make the article available to third-party indexing, abstracting, and discovery services under the CC BY 4.0 license, without the need for additional permission.
These submission terms ensure that authors understand and consent to the open-access, licensed nature of TUJNAS publications from the outset.