Methicillin Resistant Staphylococcus aureus in Health Care Workers of a Tertiary Care Infectious Disease Hospital in Nepal

Abstract

Objectives: Acquisition of mecA gene in infectious strains of Methicillin resistant Staphylococcus aureus (MRSA) are considered as one of the potential virulence factors that enables the host bacteria to carry out several nosocomial and community-acquired infections. The main aim of this study was to determine the prevalence of MRSA, their antibiogram and mecA gene in the bacterial isolates obtained from the asymptomatic healthcare workers (HCWs) working in Sukraraj Tropical and Infectious Disease Hospital (STIDH), Kathmandu Nepal.
 Methods: This prospective cross-sectional study involved the collection of nasal and hands swab of 125 randomly selected HCWs from December 2019 to February 2020. Conventional microbiological methods were used to isolate and identify S. aureus. Antimicrobial susceptibility testing was done by modified Kirby Bauer disc diffusion method. MRSA was confirmed by using cefoxitin disc. Detection of mecA gene in the chromosome which was extracted by Phenol: Chloroform: isoamyl alcohol DNA extraction method, amplified by using PCR and visualized by running agarose gel electrophoresis.
 Results: The overall and MRSA carriage rate among the HCWs was found to be 28% (35/125) and 10.4% (13/125) respectively. S. aureus carriage rate was highest among sanitation staffs (34.2%) followed by pharmacy staffs (33.3%), laboratory personnel (18.8%), doctors (9.1%) and nurses (7.5%). Similarly, 34.2% (13/38) of the S. aureus isolates were resistant to methicillin, 31.6% (12/38) were inducible-clindamycin resistant and 63.2% (24/38) of them were multi-drug resistant (MDR). All the 13 MRSA isolates harbored the mecA gene.
 Conclusions: Carriage rate of MRSA among HCWs was high and alarming, indicating the prompt need of intervention measures to curb the growth and spread of resistant isolates in the hospital settings. Effective surveillance (of infectious diseases) and establishment of advanced diagnostic facilities can assist in estimating the actual burden of the MRSA which in turn helps to formulate and implement the appropriate policies and infection-control programs to address the increasing antimicrobial resistance in the country.

Methicillin-Resistant and Biofilm-Producing Staphylococcus aureus in Nasal Carriage among Health Care Workers and Medical Students

“…Te nasal carriage rate of S. aureus among the participants was 65.3%, which is higher than that reported in studies from elsewhere in Nepal; 14.7%-15.7% [20,21]. Similarly, the prevalence of MRSA (47.4%) was higher than that in studies published from diferent settings of Nepal; 2.3%-41.3% [16,[22][23][24][25]. A meta-analysis study, between 2008 and 2020 in Nepal, noted that prevalence of MRSA ranged from 14.6% to 70.6% [26].…”

“…Out of 109 MRSA isolates, 94 (86.2%) were MDR. A similar study has noted that all the MRSA isolates were MDR [ 23 ]. Furthermore, biofilm producer S. aureus is two folds higher in number than the nonbiofilm producers.…”

Staphylococcus spp. Causatives of Infections and Carrier of blaZ, femA, and mecA Genes Associated with Resistance

“…Researchers [ 30 ] in Nepal obtained 123 CNS isolates from hospital materials in the ICU and wards; in this case, the most common species was S. epidermidis (42%), and S. haemolyticus represented 9% of isolates. Another study [ 31 ] collected nasal and hand samples from 125 health professionals from a hospital in Nepal. Of the 250 samples, 203 were identified as SCN and 38 as S. aureus .…”

Antibiotic Susceptibility, Biofilm Production, and Detection of mecA Gene among Staphylococcus aureus Isolates from Different Clinical Specimens

“…In the past, various research in Nepal looked on the phenotypic prevalence of MRSA infections [ 12 , 13 , 14 , 15 ]. MRSA frequency has been found to range from 15 to 69% in different hospitals and laboratory settings in Nepal [ 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. This study explores antimicrobial susceptibility patterns of clinical isolates of S. aureus from a tertiary hospital, examines their biofilm-forming capacity along with the detection of mec A gene.…”