Multidrug-resistant Staphylococcus aureus the excessive use of these agents in an inappropri- ate dosage regimen will favour the selection of mul- tiple drug-resistant strains that may cause serious infections with limited treatment options (17). The colonization rate of the gut with S. aureus in the study volunteers was observed to be 31.7%. This supports the findings of Bhalla et al., who reported 36.7% of S. aureus intestinal colonization in hospi- talized patients as against 50.7% nasal S. aureus in the same patients (18). There are fewer studies on the prevalence of intestinal S. aureus compared to nasal, throat, and skin, which may be as a result of the fact that the gut is not being considered an important reservoir of pathogenic staphylococci. However, several recent studies are now implicat- ing this site as an important source of transmission of antibiotic-resistant S. aureus-associated infections to the environmental surfaces of communities and hospitals (19-21). Thus, this calls for more studies on the prevalence of intestinal S. aureus in Nigeria and other developing countries where proper sani- tary systems may be inadequate in rural areas, as a measure to contain its transmission. The intestinal isolates of S. aureus were highly resist- ant to ampicillin (68.2%) and doxycycline (60.5%), with the strains from females significantly show- ing higher resistant to doxycycline than their male counterparts in both the groups (p=0.013). These observations might be due to the extensive use of these agents as observed while evaluating the use of antibiotics by these subjects. The higher resist- ance to doxycycline observed among females than among males may be due to the excessive and in- discriminate use of the agent in the treatment of pelvic inflammatory disease (22). Hence, the agents may not be useful in the treatment of infections caused by this organism. Chloramphenicol, eryth- romycin, and co-trimoxazole, which exhibited moderate activities against the strains of this organ- ism, may be useful in combination therapy against infections due to the organism. Methicillin resistance in the isolates was observed to be 34.2%, which is in contrast to the findings of Currie et al. and Baba-Mousa et al., who report- ed 62% in rectal swabs of hospitalized patients in Canada and 62% in faecal samples of antibiotic- associated diarrhoea patients in Benin respectively (23,24). This marked difference might be due to the varied health status of subjects in the studies. However, the presence of this level of MRSA isolates in stools of these healthy subjects, which exhibited multiple resistances to other agents, is an indication that the gut is an important reservoir of multidrug- resistant S. aureus. This might predisposes subjects to antibiotic-associated diarrhoea and other com- munity-associated MRSA infections (25). Volume 29 | Number 5 | October 2011 Onanuga A and Temedie TC. The number of isolates of S. aureus with reduced susceptibility to vancomycin (VISA) was 14 (36. 8%), with 57.1% of them being MRSA. This is quite higher than findings of Olonitola et al. who report- ed 2.97% in nostrils of healthy children in Zaria, Ni- geria (26). Vancomycin resistance was first noticed in Enterococcus species which normally colonized the gastrointestinal tract and the co-existence of S. aureus with it in the gut might favour the increased emergence of vancomycin-resistant S. aureus due to genetic transfer which may account for the ob- served high prevalence of VISA in this study (27). The isolates were highly susceptible to cefuroxime, augmentin, ciprofloxacin, ofloxacin, and gen- tamicin. The observed activities of the stable beta- lactam antibiotics (cefuroxime and augmentin) might be due to their intrinsic characteristics, of being resistant to the beta-lactamases of the organ- ism, coupled with their low level of misuse in the community. S. aureus isolates from other sites have been widely reported to be highly susceptible to fluoroquinolones and gentamicin (28,29), which is equally observed in this study. This makes these agents the appropriate drugs of choice in the em- pirical treatment of most infections caused by this organism since most MRSA and VISA isolates in this study were susceptible to them. This study reports a high (65.8%) level of multiple antibiotic resistance in intestinal S. aureus isolates from the healthy adults, with those from the fe- males higher than the males. Previous studies on other sites of healthy individuals reported a similar high prevalence of multiple antibiotic resistance in S. aureus (28,30). This suggests the possibility of having infections due to S. aureus with limited treatment options. Hence, there is a need to adopt measures of eradicating and preventing the trans- mission of this organism to vulnerable popula- tions, especially in women who play a vital role in the transmission. Conclusions The results of this study emphasize the importance of the gut as a reservoir and a source of transmis- sion of multiple antibiotic-resistant strains of S. aureus which might lead to more severe infections. Hence, there is a need to adopt strategies to encour- age proper personal hygiene and provide adequate effective sewage-disposal systems that will prevent the transmission of these strains to our environ- ments. Also, the need to control the excessive use and misuse of antibiotics as a means of curbing the increasing rate of antibiotic resistance in this coun- try cannot be overemphasized. 451