الفهرس 
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Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging pathogen present in the hospitals (HA-MRSA), in the community (CA-MRSA) and in livestock (LA-MRSA). MRSA has the potential to enter the human food chain and may infect humans who come into contact with food products directly. Thus, this study aimed to determine the prevalence and phenotypic antimicrobial resistance pattern of MRSA isolated from food products and food handlers at different retail outlets and superstores in Alexandria city, Egypt.
A total of 100 food products including raw milk, Damietta cheese, beef burger, sausage, and chicken pane (20 of each) as well as 100 hand swabs from food handlers were collected and screened for the presence of MRSA using MRSA selective agar medium. The MRSA isolate was confirmed from each nuc /mecA PCR-positive sample. The overall prevalence rate of MRSA in food products and food handlers was 12% and 5%, respectively.
Concerning the food products samples, the highest rate of isolation was recorded in the examined samples of beef burger (20%), followed by sausage (15%) then raw milk and chicken pane (10%) and finally Damietta cheese (5%).
The wide range of MRSA prevalence rates observed in this study may be due to lack of sufficient sanitary procedures during production, processing, handling, and distribution of food products, considering these products as a potential public health concern.
The antimicrobial susceptibility testing of the 12 MRSA isolates from food products samples clarified that all MRSA isolates showed resistance to Cefoxitin and Penicillin G. On the contrary, 100% of the isolates were sensitive to Ceftaroline and Linezolid, whereas 83.3%, 75%, 66.7%, 41.7% 25%, 16.7% and 8.3% of isolates exhibited resistance to both Gentamicin and Erythromycin, Azithromycin, Clindamycin, Sulfamethoxazole/Trimethoprim, Ofloxacin, Doxycycline and Levofloxacin, successively.
Regarding food handlers, prevalence rate was 5.3% in males and 4.2% in females. Moreover, the obtained findings showed that the highest prevalence rate was detected in age group 20-40 years old (6.5%), followed by 4.5% in age group ˂ 20 years old and it was 0% in age group > 40 years old.
The phenotypic antimicrobial resistance pattern of the 5 MRSA isolates from food handlers revealed that all (100%) MRSA isolates exhibited resistance to Cefoxitin and Penicillin G. Conversely, 100% of the isolates were sensitive to Ceftaroline and Linezolid. Meanwhile, 80%, 60%, 40% and 20% of isolates showed resistance to both Gentamicin and macrolides, Clindamycin, Sulfamethoxazole-Trimethoprim and both quinolones and Doxycycline, respectively.