Nasal carriage of methicillin resistant Staphylococcus aureus among health care workers at a tertiary care hospital in Western Nepal

Abstract

BackgroundStaphylococcus aureus is a frequent cause of infections in both the community and hospital. Methicillin-resistant Staphylococcus aureus continues to be an important nosocomial pathogen and infections are often difficult to manage due to its resistance to multiple antibiotics. Healthcare workers are important source of nosocomial transmission of MRSA. This study aimed to determine the nasal carriage rate of S. aureus and MRSA among healthcare workers at Universal College of Medical Sciences and Teaching Hospital, Nepal and to determine antibiotic susceptibility pattern of the isolates.MethodsA cross-sectional study involving 204 healthcare workers was conducted. Nasal swabs were collected and cultured on Mannitol salt agar. Mannitol fermenting colonies which were gram positive cocci, catalase positive and coagulase positive were identified as S. aureus. Antibiotic susceptibility test was performed by modified Kirby-Bauer disc diffusion method. Methicillin resistance was detected using cefoxitin disc diffusion method.ResultsOf 204 healthcare workers, 32 (15.7 %) were nasal carriers of S. aureus and among them 7 (21.9 %) were carrier of MRSA. Overall nasal carriage rate of MRSA was 3.4 % (7/204). Highest MRSA nasal carriage rate of 7.8 % (4/51) was found among nurses. Healthcare workers of both surgical wards and operating room accounted for 28.6 % (2/7) of MRSA carriers each. Among MRSA isolates inducible clindamycin resistance was observed in 66.7 % (2/3) of erythromycin resistant isolates.ConclusionsHigh nasal carriage of S. aureus and MRSA among healthcare workers (especially in surgery ward and operating room) necessitates improved infection control measures to be employed to control MRSA transmission in our setting.

Nasal Carriage Rate of Methicillin Resistant Staphylococcus aureus among Health Care Workers at a Tertiary Care Hospital in Kathmandu, Nepal

“…[16][17][18] In our study, the overall rate of nasal carriage of MRSA was found to be 7.5%, which was in accordance with the finding by Malini et al (8%). 19 However, higher rates of MRSA carriage among HCWs were reported by Pant et al 3 (54%), 3 4 Health care workers are the sources of MRSA, who are responsible for transferring of this pathogen to the patients, 3 and the haphazard use of the antibiotics may have contributed to the emergence of the MRSA. Further, the local prevalence of MRSA may have attributed to the difference in carriage rates reported by different authors.…”

“…Similarly, the higher percentage of lab personnel (10.5%) were MRSA carriers followed by nurses (9.9%) and doctors(6.4%).But in a study by Khanal et al,higher percentage of doctors (20.8%) were S. aureus carriers and higher percentage of nurses (7.8%) were MRSA carriers. 4 Similarly, Shibabaw et al reported the MRSA carriage percentage to be highest among nurses (21.2%), followed by doctors (12.5%) and laboratory technicians (12.5%) and S. aureus carriage percentage to be highest among doctors (37.5%) followed by nurses (34.6%) and laboratory technicians (25%). 20 The highest percentages of S. aureus and MRSA carriage found among laboratory personnel in our study might be due to the contact of the laboratory personnel to the infected samples received from different wards.…”

“…Further, the local prevalence of MRSA may have attributed to the difference in carriage rates reported by different authors. 4 On the basis of different professions among HCWs, the higher percentage of lab personnel (31.6%) were nasal carriers of S. aureus followed by doctors (20.6%) and nurses (18.2%). Similarly, the higher percentage of lab personnel (10.5%) were MRSA carriers followed by nurses (9.9%) and doctors(6.4%).But in a study by Khanal et al,higher percentage of doctors (20.8%) were S. aureus carriers and higher percentage of nurses (7.8%) were MRSA carriers.…”

“…[1][2][3] However, MRSA is not only the problem in hospital but also a serious problem for community due to emergence of the community acquired MRSA. 4 Health care workers(HCWs) colonized with MRSA may carry these virulent hospital strains in their nose and skin and may transmit these organisms to the community creating a more dreadful situation. 3,5 Thus there is significant role of nasal MRSA carriers in transmission of the pathogen and the health care workers may serve in cross transmission of the community acquired MRSA and hospital acquired MRSA.…”

“…3,5 Thus there is significant role of nasal MRSA carriers in transmission of the pathogen and the health care workers may serve in cross transmission of the community acquired MRSA and hospital acquired MRSA. 4 It is important to study the nasal carriage rate of MRSA among healthcare workers. In this study we determined the nasal carriage rates of S. aureus and MRSA among health care workers.…”