Methicillin-resistant Staphylococcus aureus nasal carriage among janitors working in hospital and non-hospital areas: a comparative cross-sectional study

Abstract

Background Nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA) plays a key role in the epidemiology and pathogenesis of both healthcare-associated and community-acquired MRSA infections in various populations. Screening of MRSA nasal colonization is important in the prevention and control of infection and may provide useful information to guide antimicrobial therapy. This study aimed to determine nasal carriage of MRSA, its antimicrobial susceptibility pattern, and associated factors among janitors working in hospital & non-hospital areas at the University of Gondar, Northwest Ethiopia. Methods A comparative cross-sectional study was carried out in a total of 436 study participants (221 hospital and 215 non-hospital janitors) from January to May 2019. The study participants were sampled using a simple random sampling technique. Data on socio-demographic characteristics and associated factors were collected through face to face interviews using a structured questionnaire. Nasal swabs were collected and inoculated into Mannitol salt agar. MRSA was detected using cefoxitin (30 µg) disc and an antibiotic susceptibility test was done using the disc diffusion method. Data were entered and analyzed using SPSS version 20 statistical package. P value ≤ 0.05 was considered as statistically significant. Results The overall prevalence of S. aureus was 101/436 [23.2%, (95% CI: 19.3–27.8)], of which, 29.4% (65/221) were isolated from hospital and 16.7% (36/215) non-hospital janitors. The prevalence of MRSA was 4.8% (21/436) [95% CI: 3.0–6.9]; of these, 8.1% (18/221) of the isolates were from the hospital and 1.4% (3/215) non-hospital janitors, while methicillin-sensitive S. aureus (MSSA) in hospital & non-hospital janitors were 49 (22.2%) and 31 (14.4%), respectively. Among the MRSA isolates, 52.4% (11/21) were multi-drug resistant. Of these, 42.9% (9/18) were isolated from hospital and 66.7% (2/3) non-hospital janitors. Hence, nasal carriage of MRSA was significantly associated with hospitalization within the preceding year (AOR = 3.15, CI = 1.13–8.71). Conclusion The present study revealed that high MSSA and MRSA were isolated from the hospital as compared to non-hospital janitors and high rates of antibiotics resistance were recorded in the hospital janitors. Consequently, hospitalizations were significantly associated with MRSA. Accordingly, regular screening of carriers in apparently healthy janitors is required for the prevention of nosocomial infections.

Prevalence of panton–Valentine leukocidin and toxic shock syndrome toxin-1 genes in methicillin-resistant Staphylococcus aureus isolated from nose of restaurant workers in Kirkuk city

“…[ 18 ] and similar to the results of Abie et al . and Zhu et al .,[ 19 20 ] whereas inconsistent with Gushiken et al . [ 21 ]…”

From Hospital to Community: Exploring Antibiotic Resistance and Genes Associated with Virulence Factor Diversity of Coagulase-Positive Staphylococci

“…MRSA is a significant global bacterial pathogen in various countries including Saudi Arabia [5,7,8]. The incidence of non-hospital personnel (NHP)-and hospital personnel (HP)-acquired MRSA carriers has increased since 2000 [9,10]. MRSA is a normal flora of the upper respiratory tract, particularly the nose and nasopharynx, and frequently leads to both NHP and HP carriers [10].…”

“…The incidence of non-hospital personnel (NHP)-and hospital personnel (HP)-acquired MRSA carriers has increased since 2000 [9,10]. MRSA is a normal flora of the upper respiratory tract, particularly the nose and nasopharynx, and frequently leads to both NHP and HP carriers [10]. Methicillin resistance is attributed to the expression of the mecA gene, which alters penicillin-binding protein (PBP-2) to PBP-2a, resulting in a loss of target affinity [11,12].…”

“…MRSA accounted for approximately 7.5% of all CoPS isolates studied over three years, with wound sites being the most common source [25]. In subsequent studies, MRSA was found in both NHP and HP carriers, with higher rates of multiple resistance observed among hospital carriers [10,26,27]. The prevalence of MRSA in tertiary care hospitals has been increasing in the kingdom, emphasizing the need for effective management measures [28,29].…”

Hospital outbreak of extended-spectrum beta-lactamase-producing Escherichia coli potentially caused by toilet and bath chair use

“…Moreover, the janitor's awareness of contact precautions was limited in our institution. Previous studies reported cases of meticillin-resistant Staphylococcus aureus isolated from hospital janitors as opposed to from non-hospital janitors, indicating the possibility of the janitors being vectors of the multidrug resistant strains [ 7 , 8 ]. Our case highlights that improving awareness of contact precautions among janitors is an important factor in preventing the outbreak of multidrug-resistant strains.…”