Comparison of Methicillin Resistant Staphylococcus Aureus in Healthy Community Hospital Visitors[ca-Mrsa] and Hospital Staff [Ha-Mrsa]

Abstract

BackgroundThe prevalence of community-associated methicillin-resistant Staphylococcus aureus [CA-MRSA] is unknown in Oman.MethodsNasal and cell phones swabs were collected from hospital visitors and health-care workers on sterile polyester swabs and directly inoculated onto a mannitol salt agar containing oxacillin, allowing growth of methicillin-resistant microorganisms. Antibiotic susceptibility tests were performed using Kirby Bauer’s disc diffusion method on the isolates. Minimum inhibitory concentration (MIC) was determined for vancomycin and teicoplanin against the resistant isolates of MRSA by the Epsilometer [E] test. A brief survey questionnaire was requested be filled to ascertain the exposure to known risk factors for CA-MRSA carriage.ResultsOverall, nasal colonization with CA-MRSA was seen in 34 individuals (18%, 95% confidence interval [CI] =12.5%–23.5%), whereas, CA-MRSA was additionally isolated from the cell phone surface in 12 participants (6.3%, 95% CI =5.6%–6.98%). Nasal colonization prevalence with hospital-acquired [HA] MRSA was seen in 16 individuals (13.8%, 95% confidence interval [CI] =7.5%–20.06%), whereas, HA-MRSA was additionally isolated from the cell phone surface in 3 participants (2.6%, 95% CI =1.7–4.54). Antibiotic sensitivity was 100% to linezolid and rifampicin in the CA-MRSA isolates. Antibiotic resistance to vancomycin and clindamycin varied between 9–11 % in the CA-MRSA isolates. Mean MIC for vancomycin amongst CA- and HA-MRSA were 6.3 and 9.3 μg/ml, whereas for teicoplanin they were 13 and 14 μg/ml respectively by the E-test. There was no statistically significant correlation between CA-MRSA nasal carriage and the risk factors (P>0.05, Chi-square test).ConclusionsThe prevalence of CA-MRSA in the healthy community hospital visitors was 18 % (95% CI, 12.5% to 23.5%) as compared to 13.8% HA-MRSA in the hospital health-care staff. Despite a significant prevalence of CA-MRSA, these strains were mostly sensitive. Recommendation: The universal techniques of hand washing, personal hygiene and sanitation are thus warranted.

Carriage of critically important antimicrobial resistant bacteria and zoonotic parasites amongst camp dogs in remote Western Australian indigenous communities

“…MRSA is a zoonotic and zooanthroponotic agent identified among companion animals and a global health issue. The first human community-acquired MRSA (CA-MRSA) infections were reported in Australian Aboriginal and native Canadian communities in the 1990s 18 , 19 , and studies have also reported evidence of MRSA transmission between human and companion animals 20 – 22 .…”

Foodborne disease and food control in the Gulf States

“…The authors recognized that one of the reasons for the high MSRA prevalence was cell phone use in both the community cohort and the health care worker cohort which they considered to be a public health concern. Although no risk factors were significantly associated with this high prevalence, Pathare et al (2015) recommended that universal measures of hand washing, personal sanitation and hygiene need immediate attention, through community awareness campaign programs. Cell phones have been implicated in carriage of S. aureus, including MRSA, and other bacteria in hospital settings in Ontario (Julian, Singh, Rousseau, & Weese, 2012), Kuwait (Heyba et al, 2015), and Saudi Arabia (Zakai et al, 2016).…”

“…As to be expected, Staphylococcus aureus is frequently found in Omani residents. However, the prevalence of methicillin-resistant S. aureus (MRSA) in Oman was unknown until Pathare et al (2015) compared MRSA carriage in the community visiting hospital patients (CA-MRSA) with those working in the hospitals (HA-MRSA). This study showed a relatively higher overall prevalence of CA-MRSA nasal carriage in an urban setting of 18% compared to 13.8% HA-MRSA nasal colonization.…”

“…Thus, regular cleaning of phones and proper and frequent hand hygiene should be advocated. Pathare et al (2015) indicates this should a community message as well as in hospitals, and this strategy should be implemented for all food workers, who also use cell phones.…”

Factors Associated with Methicillin Resistant Staphylococcus aureus Carriage

“…In the study on progress; a significant association between hospital visits and MRSA was found. Supporting this theory Pathare et al (2015) demonstrated that MRSA among the healthy hospital's visitors 18% is higher compared to 13.8% among health care staff in the hospitals [21]. This may be due to the continuous effective infection control policies and proper personal hygiene practices like hand washing in hospitals which might cause a lower prevalence of MRSA among healthcare personnel, contradictory, the higher prevalence among health community visitors might be they acquired in and out of hospital setting.…”