Nasal Staphylococcus aureus Carriage in Ablution Performers

Background: Nasal washing is a part of religious ablution (Wodou), which is practiced normally five times a day, as a prerequisite for the Muslims’ prayer. However, studies addressing its effect on the nasal colonization state are scarce and conflicting. Objective: to investigate whether carriage rates of nasal Staphylococcus aureus (S. aureus) would differ between performers and non-performers of ablution. Methodology: A total of 600 first-year students from Zagazig University, Egypt, were randomly selected and classified by their performance of ablution into two groups, performers and non-performers of ablution. A nasal swab was obtained from each participant and investigated for S. aureus with the standard technique. The antibiotic susceptibility of the isolated organisms was determined with the Vitek-2 system. Results: The overall S. aureus carriage rate was 30.2%. The performers of ablution had significantly lower S. aureus and methicillin-resistant S. aureus (MRSA) carriage rates than the non-performers (P<0.001 for both comparisons). In the logistic regression analysis, the most significant independent risk factor for S. aureus nasal carriage was the non-performance of regular ablution. We also found that the strains isolated from the performers, compared to non-performers, were more susceptible to antibiotics. Conclusions: Performers of ablution, compared to non-performers, have reduced carriage rates of nasal S. aureus and MRSA, and higher susceptibility profile to antibiotics. The study advocates regular ablution as an effective and inexpensive method that helps in checking the increasing problem of S. aureus antimicrobial resistance.