Nasal carriage of Staphylococcus aureus and hygiene practices among food handlers in Skopje, North Macedonia

Abstract

Nasal carriage plays a key role in Staphylococcus aureus transmission, particularly among individuals working in the food sector. The aim of this cross-sectional study was to investigate the relationship between personal hygiene and nasal carriage of S. aureus among workers in food production, distribution, and trade. It was conducted in Skopje from November 2021 to March 2022 and included 289 workers undergoing mandatory health and hygiene examinations. Data were collected through a structured questionnaire and microbiological testing of nasal swabs. The overall prevalence of S. aureus nasal carriage was 12.5 % (95 % CI: 8.7–16.3 %). Methicillin-susceptible S. aureus (MSSA) prevailed in 11.8 % (95 % CI: 8.1–15.5 %) and the methicillin-resistant variety (MRSA) in only 0.7 % (95 % CI: 0–1.7 %). We found no significant associations between nasal carriage and demographic or hygiene variables (assessed using the chi-squared test) but did observe higher carriage rates among men (15.7 %), cooks (28.6 %), and individuals with untidy nails (17 %). However, our findings should be interpreted with caution, and future studies should address the limitations of the present study. Targeted training, routine screening, and consistent adherence to good hygiene practices remain important for minimising colonisation and reducing the risk of S. aureus transmission.