Knowledge, attitude, and practices regarding methicillin-resistant Staphylococcus aureus (MRSA) infection control and nasal MRSA carriage rate among dental students of Al-Quds university, Palestine

Background: The nose is the primary colonization site of S. aureus which is a known risk factor for causing S. aureus infection. Evaluating the knowledge, attitudes, and actual practice of dental students is imperative to put together guidelines on how to achieve adequate infection control when treating patients. The purpose of this study was to assess the knowledge and attitude regarding Methicillin-resistant S.aureus (MRSA) and compliance to hygiene practices. And to determine the nasal carriage rate of S.aureus and MRSA and identifying the associated factors for S.aureus and MRSA nasal colonization among dental students in Al-Quds University– Palestine. Methods: Two-hundred eighty (280) dental students from Al-Quds University dental school were recruited to participate in a cross-sectional survey and undergo nasal sampling of MRSA. The survey included demographic questions, eight questions about knowledge, eight questions about attitudes/perceptions and six questions about practices/behaviors regarding MRSA infection control. Nasal samples from the participants were analyzed for MRSA presence and antimicrobial susceptibility. Results: Among the 280 dental students, 68 (24.3%) were S. aureus nasal carriers, whereas 21 (7.5%) were MRSA nasal carriers. Among 21 tested MRSA isolates, resistance to amoxicillin was most common (100%), followed by resistance to amoxicillin / Clavulanic acid (28.5%). Five isolates (23.8%) were found resistant to erythromycin, four isolates (19%) were resistant to clindamycin, and three isolates (14.2%) were resistant to gentamicin. None of the MRSA isolates were resistant to vancomycin. Risk factors such as using antibiotics within the previous six months, visiting a hospital recently, having a previous Staphylococcus bacterial infection and having a member of the family working in healthcare were significantly associated with carrier status (P < 0.05). The knowledge score suggests that dental students had intermediate knowledge regarding MRSA, while the attitude score showed that dental students had positive attitudes towards MRSA infection control, and the practice score suggests that the dental students’ practices regarding MRSA infection prevention are good. Conclusion: The prevalence of MRSA nasal colonization among the dental student population was higher than that reported in the Palestinian population. This indicates that the implementation of strategies on interfering with the transmission of MRSA is of utmost importance. In addition, further educating dental students on MRSA is needed to improve MRSA infection control in the dental setting.