Abstract :Development of bacterial resistance to the antibiotics constituted a major health problem.
Methicillin-Resistant Staphylococcus aureus (MRSA) is considered a prominent example.
MRSA tends to develop resistance to multiple antibiotic classes rapidly. Furthermore, MRSA
colonization was proven to be a major risk factor for infection and subsequent transmission. MRSA
decolonization by nasal mupirocin application and chlorhexidine whole-body washing are now
recommended. This study aimed to screen for the development of mupirocin and chlorhexidine
resistance among MRSA isolated from health facilities that applied decolonization protocols. A
total of 272 clinical staphylococcal isolates were investigated. 115 MRSA isolates were collected
before application of any of decolonization protocols, 81 isolates were collected from the facilities
that applied the targeted decolonization protocol and 76 isolates were collected from the facilities
that applied universal decolonization protocol. The isolated strains were identified phenotypically
and subjected to PCR for MRSA confirmation. The used PCR assay simultaneously enabled the
identification of mupirocin and chlorhexidine resistance genes. The results showed that the baseline
mupirocin resistance rate among MRSA isolates was considered moderate (13.9%). While, the
baseline chlorhexidine resistance was rare (3.5%).The resistance prevalence rates for both agents
did not change significantly during the decolonization practice. In conclusion, the application of
the decolonization strategies did not result in a significant change in MRSA susceptibility to either
mupirocin or chlorhexidine. However, these results should be interpreted with caution due the
small sample size and the relative short period passed since stating the decolonization protocols.