Background: Staphylococcus aureus is one of the most common causes of biofilm associated infections. Identification and differentiation of S. aureus with respect to its biofilm phenotype helps in diagnosis and prevention of infections related to biomedical devices.The aim of this study was to determine the rate of nasal carriage biofilm producing Methicillin Resistant S. aureus (MRSA)among Health Care Workers (HCWs)Methods and materials: A total of 232 nasal swabs were taken from HCWs at Manmohan Memorial Teaching Hospital, Kathmandu. S. aureus was isolated using Mannitol Salt Agar and identified by examination of colony characteristics, gram staining, oxidase, catalase, coagulase (slide and tube method) and Deoxyribonuclease test. Antibiotic susceptibility test was performed using the modified Kirby-Bauer disk diffusion method as recommended by Clinical and Laboratory Standards Institute guidelines. MRSA was detected phenotypically using Cefoxitin disk test. In-vitro biofilm producing capacity of isolated S. aureus was evaluated by tissue culture plate method.Results: A total of 34(14.7%) S. aureus was isolated amongst which 12(35.3%) were MRSA. Overall rate of nasal carriage MRSA was found to be 5.2% (12/232). Among 34 isolated S. aureus, 10(29.4%) were strong, 7(20.6%) were moderate, 8(23.5%) were weak biofilm producers whereas 9(26.5%) were biofilm non-producers.Among 12 MRSA, 10(83.3%) were biofilm producers of which 4(33.3%) were strong, 2(16.7%) were moderate, 4(33.3%) were weak and 2(16.7%) were biofilm-non producers whereas among 22 methicillin susceptible strains, 15(68.1%) were biofilm producers of which 6(27.3%) were strong, 5(22.7%) were moderate, 4(18.2%) were weak and 7(31.8%) were biofilm nonproducers.Incidence of methicillin resistance was higher among biofilm producers i.e. 10/25(40%) with respect to biofilm nonproducers i.e. 2/9(22.2%). All isolated strains were found susceptible to Vancomycin, Tetracycline and Teicoplanin.Conclusion::Our study suggests that the rate of nasal carriage ebiofilm producing MRSA is very high among HCWs with decreased susceptibility to antimicrobials.Hence, proper identification and treatment of carrier HCWs can help to minimize medical device associated as well as other HCW associated infections.
Background: Lassa fever (LF) is an acute viral haemorrhagic illness of a 2–21-day incubation period that occurs in West Africa. It is endemic in Nigeria and peaks during the first 12 weeks of the year. On January 22, 2019, the Nigeria Centre for Disease Control (NCDC) declared an outbreak of LF following an upsurge of LF cases in the country. A total of 213 confirmed cases including 41 deaths were reported from sixteen states including Ondo State. A multi-sectoral national rapid-response-team (RRT) was deployed to Ondo State to characterise the outbreak, assess its determinants, and institute control measures. Methods: An Emergency Operations Center (EOC) was activated to coordinate activities. We defined a suspected case as anyone with one or more of the following symptoms: malaise, fever, headache, sore throat, cough, vomiting and either history of contact with rodents, or a probable or confirmed LF case in the past 21 days, or any person with inexplicable bleeding between January 1, 2019, to February 26, 2019, in Ondo State. A confirmed case was any suspected case with laboratory confirmation. We conducted active case search, collected data using the LF case investigation form and reviewed the existing line list. We conducted contact tracing in hospitals and affected Local Government Areas (LGA). Data was analysed using and Epi info 7.0. Results: We identified 287 LF suspected cases in 6 LGAs; 118 were confirmed with 21 deaths (case fatality rate: 17.8%). The mean age was 39.2 ±20 years with a male-to-female ratio of 1.3:1. Of the 1,269 contacts line-listed, 20 became symptomatic, while 14 (70.0%) were confirmed positive. The secondary attack rate was 1.1%. Conclusion: The confirmed cases were more of primary cases, hence the need to focus more on reducing rodent-to-human transmission of LF. We recommend continuous education on community and health facility infection prevention control, contact tracing and enforcement of environmental sanitation measures across the state to mitigate future outbreaks
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