The Prevalence of Nasal Carriage of Staphylococcus Aureus Among Healthcare Workers at a Tertiary Care Hospital in Assam with Special Reference to MRSA

Abstract

Background: The recent years have witnessed the increasing resistance of Staphylococcus aureus to many antimicrobial agents. The most notable example is the emergence of Methicillin-resistant Staphylococcus aureus (MRSA), which was reported just one year after the launch of methicillin. The ecological niches of the S. aureus strains are the anterior nares. The identification of Staphylococcus aureus by using a proper antibiogram and the detection of methicillin resistant Staphylococcus aureus greatly contribute towards the effective treatment of the patients. Aims and Objectives:To isolate Staphylococcus aureus from the nasal swabs of healthcare workers (HCWs) and to study their antimicrobial susceptibility patterns, which include methicillin resistance. Materials and Methods:Nasal swabs were collected from the healthcare workers of various clinical departments of the hospital over a period of one year. The isolation of Staphylococcus aureus and their antimicrobial susceptibility patterns were carried out by standard bacteriological procedures. Results:Staphylococcus aureus was isolated in 70 cases (22.22%). The prevalence of the S.aureus nasal carriage was higher among the male HCWs (54.28%) than among the female HCWs (45.71%). The carriage rate was the highest in the orthopaedics department, followed by those in the surgery and the gynaecology departments. All the Staphylococcus aureus isolates were sensitive to vancomycin and linezolid (100%). Penicillin and ampicillin were the most resistant, (90% and 88.6%) respectively. Methicillin resistance was seen in11.43% of the S.aureus isolates, both by the disc diffusion test and by the Oxacillin Resistance Screen Agar (ORSA) test.

Prevalence of Methicillin Resistant Staphylococcus aureus Carriage amongst Health Care Workers of Critical Care Units in Kasturba Medical College Hospital, Mangalore, India

“…However, the MRSA carriage rate among health care personnel who were involved in the critically ill patients was only 2.5%., which was significantly lower than that of 4.6% (p < 0.01) which was reported in a meta-analysis of 127 investigations which was done around the world, which involved screening of 33,318 healthcare workers the world over [13]. Our finding for MRSA was marginally high as compared to the earlier report (1.8%) which was obtained from Pondicherry [19], but it was significantly low as compared to the findings of studies which were carried out in other two parts of India, Assam (11.48%) and Bangalore (10%) respectively [24,25]. We have effectively functioning Hospital Infection Control Committee policies, which may be responsible for absence of MRSA carrier state among doctors, internees, student auxiliary staff, student nursing trainees and physiotherapists.…”

<b>Prevalência e perfil de sensibilidade de staphylococcus aureus isolados em pacientes e equipe de enfermagem</b> DOI: 10.4025/cienccuidsaude.v12i3.17609

“…A multirresistência, incluindo a resistência à oxacilina, conforme observado neste estudo, pode trazer dificuldades no que diz respeito à terapia empregada no tratamento de infecções causadas por esse micro-organismo (14) . (13) .…”

“…Outros estudos já realizados apontaram uma significativa redução no isolamento de S. aureus após o uso de mupirocina, com taxas variando de 75 a 91% (14,27,28) . Entretanto, o uso rotineiro da descolonização em pacientes portadores de MRSA, mas que não são considerados como de alto risco, não é bem validado cientificamente, e a eficácia desta estratégia por tempo prolongado ainda não é clara, havendo necessidade de se avaliar a relação custobenefício e a possibilidade de desenvolvimento de resistência à mupirocina (27,29) .…”

“…Isto porque, o ser humano é o principal reservatório de S. aureus e a rota de transmissão cruzada se dá pelas fossas nasais para as mãos de profissionais de saúde e, posteriormente, alcançam o paciente. Outra possibilidade de disseminação do microorganismo é pela via endógena, a partir da colonização da cavidade nasofaríngea (14,15) . Assim, a determinação da prevalência de carreamento por MRSA é uma estratégia epidemiológica importante para a proposição de medidas de prevenção, controle e também um dos critérios mais utilizados para a escolha da terapêutica (8,15) .…”

A surveillance of MRSA nasal carriage in Community and Health Care Workers

“…S. aureus are the common inhabitants of various body sites (Wertheim et al 2005), and are most prevalent in anterior nares. In-effect the nares provide the principal reservoir for these organisms (Rongpharpi et al 2013).…”