Methicillin-resistant Staphylococcus sp. colonizing health care workers of a cancer hospital

Abstract

The aim of the study was to analyze epidemiological and microbiological aspects of oral colonization by methicillin-resistant Staphylococcus of health care workers in a cancer hospital. Interview and saliva sampling were performed with 149 health care workers. Antimicrobial resistance was determined by disk diffusion and minimum inhibitory concentration. Polymerase Chain Reaction, Internal Transcribed Spacer-Polymerase Chain Reaction and Pulsed Field Gel Electrophoresis were performed for genotypic characterization of methicillin-resistant Staphylococcus. Risk factors were determined by logistic regression. Methicillin-resistant Staphylococcus colonization prevalence was 19.5%, denture wearing (p = 0.03), habit of nail biting (p = 0.04) and preparation and administration of antimicrobial (p = 0.04) were risk factors identified. All methicillin-resistant Staphylococcus were S. epidermidis, 94.4% of them had mecA gene. Closely related and indistinguishable methicillin-resistant S. epidermidis were detected. These results highlight that HCWs which have contact with patient at high risk for developing infections were identified as colonized by MRSE in the oral cavity, reinforcing this cavity as a reservoir of these bacteria and the risk to themselves and patients safety, because these microorganisms may be spread by coughing and talking.

Methicillin-resistant Staphylococcus spp. in the nasal cavity of dental surgeons professors

“…MRSE was the microorganism that showed to accumulate the highest number of drug resistance mechanisms, being intermediate to ciprofloxacin and norfloxacin, and resistant to trimethoprim/sulfamethoxazole. Similar results were reported for MRSE isolated from HCW in a cancer hospital centre (Costa et al, 2014), pointing to the need for follow-up cultures of these microorganisms given the multidrug-resistance and the difficulty for the infection treatment (Soumya et al, 2017). Inducible MLS B complex resistance was observed in MRSE and MRSA 1 isolates and resistance to mupirocin in MRSA 1.…”

“…Among dentists, prolonged exposure to procedures in which there is production of aerosols was associated with the presence of symptoms such as persistent or productive cough, nasal congestion, runny nose, sneezes, eye irritation, cutaneous eruptions, pruritus or dry skin (Allsopp et al, 1997). These findings indicate bacterial colonization as an adjuvant in the occurrence of adverse effects in occupational health (Costa et al, 2014;Albrich and Harbarth, 2008).…”

“…Colonization status poses risks to the HCW since, in an episode of imbalance of the microbiota and immune system, an endogenous infection may be developed (Kim et al, 2018;Zervou et al, 2014;Albrich and Harbarth 2008). In addition, it poses risks to the patient, once the colonized HCW becomes a reservoir and a potential source of bacteria in the epidemiological chain of Healthcare-Associated Infections (HAI) (Ugolotti et al, 2018;Kim et al, 2018;Zervou et al, 2014;Costa et al, 2014;Albrich and Harbarth 2008). However, studies on the colonization of dental HCW with multidrug-resistant bacteria are scarce (Khairalla et al, 2017), particularly, in clinical practice in higher educational institutions, which reflects the reality of clinical care treatments in outpatient dental clinics.…”

A preliminary study of mecA gene expression and methicillin resistance in staphylococci isolated from the human oral cavity

“…Although staphylococci are known to be frequent colonizers of the oral cavity, the incidence of methicillin resistance in oral staphylococci is poorly studied. 1,2,24 Hence, the current study investigated methicillin resistance and the responsible mecA gene in oral staphylococci isolated from a group of Sri Lankan patients.…”

Occurrence of the vanA gene in Staphylococcus epidermidis from nasopharyngeal secretion of Health-Care Workers, Recife, Brazil

“…The occurrence of HAIs caused by Staphylococcus isolates carrying the vanA gene has been reported worldwide, associated with different patterns of infections, mainly in the US and in Brazil 11,22,[37][38][39][40][41]24 . Some studies correlate methicillin resistance to vancomycin tolerance due to vancomycin treatment failures in cases of infections caused by methicillin-resistant microorganisms 7,[42][43][44] .…”