Nasal carriage of Methicillin Resistant Staphylococcus aureus among health care workers in a tertiary care hospital
Keywords:
Methicillin resistant Staphylococcus aureus, Nasal carriage, Health care workers
Abstract
Introduction: Hospital acquired infections especially with methicillin resistant Staphylococcus aureus (MRSA) is an important cause of morbidity and mortality. Staphylococcus aureus remains as a significant and potential pathogen because of its severity and increased frequency in causing a wide array of infections. The most common infections caused by S. aureus include skin and soft tissue, musculoskeletal system, respiratory system, central nervous system, endovascular system &genitourinary system. It has become one of the leading causes of hospital acquired infections and are very difficult to treat because of increase in resistance to antimicrobial drugs.
Aim and objectives: This study aims to screen for nasal carriage of Staphylococcus species, Methicillin Resistant Staphylococcus aureus (MRSA) and Methicillin Sensitive Staphylococcus aureus (MSSA) among the health care workers as they are potentially endangered target groups in a health care setting.
Materials and Methods: The study was carried out in a tertiary care hospital for a period of 6 months from June 2018 to December 2018. Nasal swab samples were obtained from a total of 120 health care workers. Culture and sensitivity was performed by standard microbiological methods. Methicillin resistance was tested by using Cefoxitin disc (30μg) by Kirby-Bauer disk diffusion method on Mueller Hinton Agar.
Results: Out of the 120 samples, 86 (72%) samples were bacterial culture positive and 34(28%) samples were culture negative. Among the 86 clinical isolates, 38 (31.6%) were of Staphylococcus aureus, 26 (21.6%) were of Coagulase negative Staphylococcus aureus (CONS) and 22 (18.3%) samples were of bacteria other than Staphylococci.
Conclusion: A higher rate of nasal carriage of MRSA was observed among the health care workers. Henceforth, routine screening of MRSA among the hospital staffs is recommended.
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References
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29. Goyal R, Das S, Mathur M. Colonisation of methicillin resistant Staphylococcus aureus among health care workers in a tertiary care hospital of Delhi. Indian J Med Sci. 2002;56(7):321-324.
30. Malini J, Shruti AH, Padmavathy M, Umapathy BL, Navaneeth BV, KeerthiMannan J, Girish MS. Methicillin-resistant Staphylococcus aureus carriage among the health care workers in a tertiary care hospital. JCDR. 2012;6(5):791-793.
31. Khanal R, Sah P, Lamichhane P, Lamsal A, Upadhaya S, Pahwa VK. Nasal carriage of methicillin resistant Staphylococcus aureus among health care workers at a tertiary care hospital in Western Nepal. Antimicrob Resist Infect Control. 2015;4:39. doi: 10.1186/s13756-015-0082-3.
32. Shibabaw A, Abebe T, Mihret A. Nasal carriage rate of methicillin resistant Staphylococcus aureusamongdessie referral hospital health care workers; dessie, northeast Ethiopia. Antimicrob Resist Infect Control. 2013;2(1):25. doi: 10.1186/2047-2994-2-25.
33. Stefani S, Chung DR, Lindsay JA, et al. Methicillin resistant Staphylococcus aureus (MRSA): global epidemiology and harmonization of typing methods. Int J Antimicrob Agents.2012;39(4):273-282. doi: 10.1016/j.ijantimicag.2011.09.030.
34. Appelbaum PC. Microbiology of antibiotic resistance in Staphylococcus aureus. Clin Infect Dis. 2007;45(3):171-176. doi:10.1086/519474.
2. Cosgrove SE, Sakoulas G, PerencevichEn, Scwaber MJ, Karchmer AW, Carmeli Y. Comparison of mortality associated with methicillin resistant and methicillin susceptible Staphylococcus aureus bacteremia: a metaanalysis. Clinical Infect Dis. 2003;36(1):53-59. doi:10.1086/345476.
3. Christian Cespedes, Maureen Miller, Bianca Quagliarello, Peter Vavagiakis, Robert S. Klein, and Franklin D. Lowy. Differences between Staphylococcus aureus isolates from medical and Nonmedical Hospital Personnel. J Clinic Microbiol. 2002;40(7):2594-2597. doi: 10.1128/JCM.40.7.2594-2597.2002.
4. Sah P, Raj Rijal K, Shakya B Raj, B.T. Ghimire P. Nasal carriage rate of Staphylococcus aureus in hospital personnel of National Medical College and Teaching Hospital and their Antibiotic Susceptibility Pattern. JHAS. 2013;3(1):21-23. doi: 10.12691/ajmr-2-4-1.
5. Lowy FD. Antimicrobial resistance: the example of Staphylococcus aureus. J Clin Invest. 2003; 111(9):1265-1273. doi:10.1172/JCI18535.
6. Ghidey F, Igbinosa O, Igbinosa E, Nasal colonization of methicillin resistant Staphylococcus aureus (MRSA) does not predict subsequent infection in the intensive care unit. J Basic App Sci. 2014;3(2):81-86. doi: https://doi.org/10.1016/j.bjbas.2014.03.001.
7. Sisirak M, Zvizdic A, Hukic M. Methicillin-resistant staphylococcus aureus (mrsa) as a cause of nosocomial wound infections. Bosnian J Basic Med Sci. 2010;10(1):32-37. doi: 10.17305/bjbms.2010.2733.
8. Campos M.L, Cipriano Z.M, Freitas P.F. Suitability of the NNIS index for estimating surgical-site infection risk at small university hospital in Brazil. Infect Control Hosp. Epidemiol.2001;22(5):268-272. doi:10.1086/501898.
9. Haddadin AH, Fappiano SA, Lipset PA. Methicillin-resistant 4 (MRSA) in the intensive care unit. Postgrad Med J. 2002;78(921):385-392. doi:10.1136/pmj.78.921.385.
10. David MZ, Daum RS. Community-associated methicillin- resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev.2010;23(3):616-687. doi: 10.1128/CMR.00081-09.
11. Hiramatasu K, Aritaka N, Hanaki H, Ino T, Yabuta K. Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vancomycin. Lancet 1997:350,1670-1673. doi:10.1016/S0140-6736(97)07324-8.
12. Tenover F.C, Lancaster M.V, Hill B.C. Characterization of staphylococci with reduced susceptibilities to vancomycin and other glycopeptides. J Clin Microbiol.1998;36(7):1020-1027.
13. Kim M.N, Pai C.H, Woo Ryu J.H, Hiramatsu K. Vancomycin intermediate Staphylococcus aureus in Korea. J Clin Microbiol.2000;38(10):3879-3881.
14. Srinivasan A, Dick J.D, Perl T.M. Vancomycin resistance in staphylococci. Clin Microbiol Rev. 2002;(15) :430-438.doi:10.1128/cmr.15.3.430-438.2002.
15. National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 [ through June 2004] issued October 2004. Am J Infect Control.2004;32(8):470-485. doi:10.1016/S0196655304005425.
16. Kalenic S. The Resistance of Bacteria to Antibiotics. Medicus.2009;9(2):149-158.
17. Damani N.N. Methicillin-resistant Staphylococcus aureus. Manual of Infection Control Procedures. 2003;121-129.
18. Bannerman Tl,Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH. Staphylococcus, Micrococcus and other catalase-positive cocci that grow aerobically In: Manual of clinical microbiology 8. Th. Washington. DC.ASM Pres.2003:383-404.
19. Sader HS, Farrell DJ, Jones RN. Antimicrobial susceptibility of Gram-positive cocci isolated from skin and skin-structure infections in European medical centres. Int J Antimicrob Agents. 2010; 36:28–32. doi: 10.1016/j.ijantimicag.2010.03.016.
20. Verma S, Joshi S, Chitnis V, Hemwani N, Chitnis D. Growing problem of methicillin resistant Staphylococci: Indian scenario. Indian J Med Sci.2000;54(12):535-540.
21. Rajaduraipandi K, Mani KR, Panneerselvam K, Mani M, Manikandan P. Prevalence and antimicrobial susceptibility pattern of methicillin resistant S. aureus: a multicentre study. Indian J Med Microbiol.2006;26(1):34-38. doi:10.4103/0255-0857.19892.
22. Gopalakrishnan R, Sureshkumar D. Changing trends in antimicrobial susceptibility and hospital acquired infections over an 8 year period in a tertiary care hospital in relation to introduction of an infection control programme. J Assoc Physicians India. 2010;58:25-31.
23. Elie-Turenne MC, Fernandes H, Mediavilla JR, Rosenthal M, Mathema B, Singh A, et al. Prevalence and characteristics of Staphylococcus aureus colonization among healthcare professionals in an urban teaching hospital. Infect Control Hosp Epidemiol.2010;31(6):574-580. doi: 10.1086/652525.
24. Akhtar N. Staphylococcal nasal carriage of health care workers. J Coll Phys Surg.2010;20(7):439-443. doi: 07.2010/JCPSP.439443.
25. El Aila NA, Al Laham NA, Ayesh BM. Nasal carriage of methicillin resistant Staphylococcus aureus among health care workers at Al Shifa hospital in Gaza Strip. BMC Infect Dis. 2017;17:28. doi:10.1186/s12879-016-2139-1.
26. Askarian M, Zeinalzadeh A, Japoni A, Alborzi A, Memish ZA. Prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus and its antibiotic susceptibility pattern in healthcare workers at Namazi Hospital, Shiraz, Iran. Int J Infect Dis. 2009;13(5):e241–247. doi:10.1016/j.ijid.2008.11.026.
27. Zorgani A, Elahmer O, Franka E, Grera A, Abudher A, Ghenghesh KS. Detection of meticillin-resistant Staphylococcus aureus among healthcare workers in Libyan hospitals. J Hosp Infect. 2009;73(1):91–92. doi:10.1016/j.jhin.2009.06.019.
28. Kampf G, Adena S, Ruden H, Weist K. Inducibility and potential role of MecA-gene-positive oxacillin-susceptible Staphylococcus aureus from colonized healthcare workers as a source for nosocomial infections. J Hosp Infect. 2003;54(2):124-129. doi:10.1016/s0195-6701(03)00119-1.
29. Goyal R, Das S, Mathur M. Colonisation of methicillin resistant Staphylococcus aureus among health care workers in a tertiary care hospital of Delhi. Indian J Med Sci. 2002;56(7):321-324.
30. Malini J, Shruti AH, Padmavathy M, Umapathy BL, Navaneeth BV, KeerthiMannan J, Girish MS. Methicillin-resistant Staphylococcus aureus carriage among the health care workers in a tertiary care hospital. JCDR. 2012;6(5):791-793.
31. Khanal R, Sah P, Lamichhane P, Lamsal A, Upadhaya S, Pahwa VK. Nasal carriage of methicillin resistant Staphylococcus aureus among health care workers at a tertiary care hospital in Western Nepal. Antimicrob Resist Infect Control. 2015;4:39. doi: 10.1186/s13756-015-0082-3.
32. Shibabaw A, Abebe T, Mihret A. Nasal carriage rate of methicillin resistant Staphylococcus aureusamongdessie referral hospital health care workers; dessie, northeast Ethiopia. Antimicrob Resist Infect Control. 2013;2(1):25. doi: 10.1186/2047-2994-2-25.
33. Stefani S, Chung DR, Lindsay JA, et al. Methicillin resistant Staphylococcus aureus (MRSA): global epidemiology and harmonization of typing methods. Int J Antimicrob Agents.2012;39(4):273-282. doi: 10.1016/j.ijantimicag.2011.09.030.
34. Appelbaum PC. Microbiology of antibiotic resistance in Staphylococcus aureus. Clin Infect Dis. 2007;45(3):171-176. doi:10.1086/519474.
CITATION
DOI: 10.17511/jopm.2019.i11.08
Published: 2019-11-30
How to Cite
Krishnakumar, S., Krishnasamy, L., Krishnagopal, V., & Saikumar, C. (2019). Nasal carriage of Methicillin Resistant Staphylococcus aureus among health care workers in a tertiary care hospital. Tropical Journal of Pathology and Microbiology, 5(11), 878-883. https://doi.org/10.17511/jopm.2019.i11.08
Section
Original Article
OAI - Open Archives Initiative
