Nasal Carriage of Methicillin-Resistant Staphylococcus aureus among Healthcare Workers in a Tertiary Care Hospital, Kathmandu, Nepal

Abstract

Introduction. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common causes of nosocomial infections. One of the potential risk factors for nosocomial staphylococcal infections is colonization of the anterior nares of healthcare workers (HCWs). Our study aimed to determine the rate of nasal carriage MRSA among HCWs at Manmohan Memorial Medical College and Teaching Hospital, Kathmandu. Methods. Two hundred and thirty-two nasal swabs were collected from HCWs of Manmohan Memorial Medical College and Teaching Hospital, Kathmandu, Nepal, within six months (February 2018–July 2018). Nasal swabs were cultured, and S. aureus isolates were subjected to the antimicrobial susceptibility test by the modified Kirby–Bauer disc diffusion method. MRSA and iMLSB (inducible macrolide lincosamide streptogramin B) resistance was screened using the cefoxitin disc (30 μg) and D-test (clindamycin and erythromycin sensitivity pattern), respectively, following CLSI (Clinical and Laboratory Standard Institute) guidelines. Risk factors for MRSA colonization were determined using the chi-square test considering the p value ˂0.05 as significant. Results. A total of 34/232 (14.7%) S. aureus were isolated, out of which 12 (35.3%) were MRSA. The overall rate of nasal carriage MRSA among HCWs was 5.2% (12/232). Colonization of MRSA was higher in males (8.7%) than in females (4.3%). MRSA colonization was found to be at peak among the doctors (11.4%). HCWs of the postoperative ward were colonized highest (18.2%). All MRSA isolates were sensitive to linezolid and tetracycline. iMLSB resistance was shown by 7(20.6%) of the isolates. MRSA strains showed higher iMLSB resistance accounting for 33.3% (4/12) in comparison to methicillin-susceptible strains with 13.6% (3/22). Smoking was found to be significantly associated with MRSA colonization ( p = 0.004 ). Conclusion. Rate of nasal carriage MRSA is high among HCWs and hence needs special attention to prevent HCW-associated infections that may result due to nasal colonization.

Nasal Carriage of Staphylococcus Aureus in Pharmacist and Pharmacy Personnel

“…As a result, bacterial colonization is facilitated, the inflammatory response is exacerbated, host immunity is further impaired, bacterial colonization is promoted in the respiratory tract [29]. Our study was consistent with studies in which smoking was found to be a risk factor of S. aureus carriage [21,29,30]. In many studies, it has been reported that diabetes increases the colonization of S. aureus [32][33][34][35][36].…”

High Prevalence of Nasal carriage of Methicillin Resistant Coagulase Negative Staphylococci among Medical Students in a Tertiary Care Institution in North India

“…Overall prevalence of MRSA among all students was 4% (6/150). Several studies have reported rates of nasal carriage of MRSA among healthcare staff ranging from 5.2%-25.5% 7,8,9 . Our rate of 23.2% S.aureus and 4% MRSA is comparable to Baroja et al,2021 from Ecuador 10 .…”

Detection of Biofilm Production and Antibiotic Susceptibility Pattern among Clinically Isolated Staphylococcus aureus

“…In brief, 0.5 McFarland standard bacterial suspension was lawn cultured on MHA plates on which the erythromycin disc (15 µ g) and clindamycin disc (2 µ g) were placed 15 mm apart from edge to edge. The plates were incubated aerobically at 37°C for 24 hr; if the isolate was resistant to erythromycin (zone diameter ≤13 mm) and susceptible to clindamycin (zone diameter ≥21 mm) with a D-shaped zone around clindamycin, it was considered positive for inducible clindamycin resistance [ 3 ] ( Figure 1 ).…”

“…Staphylococcus aureus , a virulent human pathogen, is the most known cause of community and nosocomial infections. Almost 41% of the general population carries S. aureus, colonizing the upper respiratory tract asymptomatically as a human microbiota, which might serve as a source for invasive infections [ 1 ], resulting in minor to severe systemic infections such as pulmonary infections, and infective endocarditis, leading to treatment failures and death [ 2 , 3 ]. With the improper use of multiple drugs and development of resistance to the drugs, their ability to form biofilm, S. aureus is capable of causing diverse infections not responsive to the usual therapy [ 4 ].…”