Methicilin Resistant <i>Staphylococcus aureus</i> Carriage amongst Healthcare Workers of the Critical Care Units in a Nigerian Hospital

Abstract

Problem statement: Methicilin Resistant Staphylococcus Aureus (MRSA) Nosocomial Infection (NI) outbreaks and prevalence among various populations are well reported in literature particularly for developed countries. NI due to MRSA is a known cause of increased hospital stay, cost, morbidity and mortality especially among the critically ill. There is paucity of information on MRSA in developing nations including the carriage by critical healthcare givers who are potential transmitters. In most hospital in developing countries like Nigeria, there is neither surveillance system or control policy for MRSA. Approach: We screened healthcare workers in the critical care units of the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria for MRSA and determined vancomycin susceptibility of the isolates. Swabs of both anterior nares and web spaces of the hands were taken, transported and incubated in Tween 80 at 35°C overnight aerobically before inoculation onto Mannitol Salt Agar (MSA). Inoculated MSA were incubated aerobically at 35°C for 18-24 h. Staphylococcus aureus was identified as Gram positive cocci with positive catalase, coagulase and DNAse test. MRSA were identified by combined oxacillin and cefoxitin discs diffusion method. Sensitivity to vancomycin was by vancomycin discs diffusion and vancomycin agar screen plating. Results: Of the 198 healthcare workers screened, 104 had MRSA either in the nose, hand or both giving a carriage rate of 52.5%. Nasal carriage (38.9%) was higher than hand (25.3%). Doctors (22.7%) and Nurses (16.7%) were the predominant carriers. MRSA isolates were resistant to commonly available antibiotics. Only 1 (1.3%) of the nasal isolates was vancomycin resistant. Conclusion: MRSA carriage among healthcare workers in the critical care units of the Nigerian hospital is high with doctors and nurses being the major carriers. The MRSA isolates were multi-drug resistant which may lead to increased morbidity and mortality if transmitted to the critically-ill. There is need for MRSA control policies in hospitals with settings of our type.

Handwashing Practices amongst Health Workers in a Teaching Hospital

“…Our study supports findings by other studies that rates of hand washings with soap and water before interacting with patients are low (Bischoff et al, 2000;Pittet et al, 1999a;Lankford et al, 2003;Sproat and Inglis, 1994;Fadeyi et al, 2010). The rates were higher after patients interactions, confirming the suggestions of some authors that health workers hand washing rates increases when there is perceived risk for their own health (Bischoff et al, 2000;Pittet et al, 1999a;Lankford et al, 2003).…”

Epidemiology of oxacillin-resistant staphylococcus aureus from cell phones of health-care workers in Ekiti State

“…Resistant strains especially Oxacillin resistant S. aureus (ORSA) has become the most common cause of nosocomial infections worldwide [38] with this study finding 55% ORSA isolates. This finding agrees with that reported by [39] who observed 52.5% ORSA amongst health-care workers of University of Ilorin Teaching Hospital. Also, [40] recovered 20% S. aureus from 250 phones sampled and observed that they showed high resistance to oxacillin.…”

Nasal Carriage of Staphylococcus Aureus and the Quantum of Their Methicillin Resistance Amongst the Health Care Workers in a Peripheral Tertiary Care Centre of Eastern India

“…In other words education level has got no impact on the carriage of MRSA in health care workers. Higher carriage rate of MRSA amongst Doctors and Nurses was observed by Zermina et al 22 (18.5% & 27.3%), Ahmed et al 21 (All Doctors) and Fadeyi et al 5 (22.7% & 16.7%). In ward wise distribution of nasal carriage of MRSA in the present study it is observed that G&O and Medicine ward contributes maximum (25% each) in comparison to others (Orthopedics 16.6%, Surgery 16.6% and Pediatrics 16.6%).…”