# Community carriage of methicillin-resistant staphylococci among migrant communities living in Klang Valley, Malaysia

## TL;DR

Migrant workers in Malaysia have high rates of methicillin-resistant staphylococci, with crowded living conditions and antibiotic resistance linked to their spread.

## Contribution

First report of community carriage of methicillin-resistant staphylococci among migrant workers in Malaysia.

## Key findings

- 14.7% of migrant workers carried methicillin-resistant staphylococci, with Indonesian workers having the highest prevalence.
- MRSH was the most commonly isolated species, and many isolates showed resistance to multiple antibiotics.
- SCCmec types I and V were predominant in MRSH, while type IV was common in MRSA and MRSE.

## Abstract

•Migrant workers in Malaysia carry methicillin-resistant staphylococci (MRS).•Crowded living conditions are significantly linked to migrant MRS community carriage.•Varied antibiotic resistance profiles in migrant community carriage MRS.•MRS carriage among pink-collar migrant workers warrants surveillance.

Migrant workers in Malaysia carry methicillin-resistant staphylococci (MRS).

Crowded living conditions are significantly linked to migrant MRS community carriage.

Varied antibiotic resistance profiles in migrant community carriage MRS.

MRS carriage among pink-collar migrant workers warrants surveillance.

This study aimed to determine community carriage of methicillin-resistant Staphylococcus aureus (MRSA), S. epidermidis (MRSE), and S. haemolyticus (MRSH) among migrant workers from Indonesia, Bangladesh, and Nepal residing in Klang Valley, Malaysia.

A total of 258 migrant workers were recruited for nasal swab screening of MRSA, MRSH and MRSE. Swabs were cultured on CHROMagar™ MRSA, and colonies exhibiting growth were subjected to species identification, antibiotic susceptibility testing and SCCmec typing.

Among 258 participants, 38 (14.7%) carried methicillin-resistant staphylococci (MRS), with Indonesian workers having the highest prevalence (n = 19, 50.0%). Among the MRS, MRSH was mostly commonly isolated (n = 18, 40.0%), followed by MRSA (n = 11, 24.4%) and MRSE (n = 2, 4.4%). Many isolates were resistant to erythromycin (n = 24, 53.3%), tetracycline (n = 17, 37.8%), ciprofloxacin (n = 17, 37.8%) and clindamycin (n = 17, 37.8%). SCCmec types I and V were predominantly found in MRSH (n = 20, 80.0%), while type IV was most common in MRSA (n = 10, 90.9%) and MRSE (n = 5, 55.6%).

This is the first report of community carriage MRS in migrant workers living in Malaysia. Silent MRS carriage in pink-collar industries, such as domestic helpers might have local community transmission implications and could be further investigated.