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

Khatri, Sabita; Pant, Narayan Dutt; Bhandari, Rita; Shrestha, Krishma Laxmi; Shrestha, Chandrika Devi; Adhikari, Nabaraj; Poudel, Asia

doi:10.3126/jnhrc.v15i1.18009

Cited by 21 publications

(30 citation statements)

References 10 publications

(22 reference statements)

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“…To our best knowledge, five studies from Nepal characterized MRSA in hospital settings obtained from both, patients or healthcare workers (Ansari et al, 2014; Pahadi et al, 2014; Shrestha et al, 2014; Pokhrel et al, 2016; Khatri et al, 2017). Isolation rates varied from 14.6 to 69%.…”

Section: Introductionmentioning

confidence: 99%

MRSA Strains in Nepalese Rhesus Macaques (Macaca mulatta) and Their Environment

Roberts

Joshi²,

Monecke

et al. 2019

Front. Microbiol.

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This study looked at 227 saliva samples from Rhesus macaques (Macaca mulatta) and 218 samples from the surrounding environments. From these samples, MRSA isolates were collected from Rhesus saliva samples (n = 13) and environmental samples (n = 19) near temple areas in Kathmandu, Nepal. For comparison, selected MRSA isolates (n = 5) were obtained from patients with wound infections from a Kathmandu hospital. All isolates were characterized using Abbott StaphyType® DNA microarrays. Eighteen isolates (62%) from monkeys (n = 4; 31%) and environmental samples (n = 14; 74%), were CC22-MRSA-IV. Most (n = 16) of them carried both, the PVL locus and toxic shock toxin gene (tst1), an unusual combination which is the same as in previously characterized strain from Nepalese macaques and pigs. The five human isolates also belonged to that strain type. Eight monkey MRSA isolates were CC361-MRSA-IV. One MRSA from a monkey and one from an environmental sample, were CC88-MRSA-V. Other environmental MRSA included one each, CC121-MRSA-VT, and CC772 -MRSA-V. Two were CC779-MRSA-VT, potentially a novel clone. All MRSA carried the blaZ gene. The aacA–aphD, dfrA, and erm (C) genes were very common in isolates from all sources. One macaque MRSA carried the resistance genes aphA3 and sat, neither previously identified in primate MRSA isolates. This current study suggests that humans could be a potential source of the MRSA in the macaques/environment and transmission may be linked to humans feeding the primates and/or living in close proximity to each other.

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Section: Introductionmentioning

confidence: 99%

MRSA Strains in Nepalese Rhesus Macaques (Macaca mulatta) and Their Environment

Roberts

Joshi²,

Monecke

et al. 2019

Front. Microbiol.

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“…Khatri S et al also found MRSA nasal carriage in highest proportion in lab technicians 10.5% followed by nurses 9.9% like our study. 24 El-Aila NA et al found highest prevalence of MRSA among nurses (30.4%), after that in doctors (16%). 25 Shibabaw A et al also found highest MRSA prevalence among nurses.…”

Section: Discussionmentioning

confidence: 94%

“…Khatri S et al and El-Aila NA et al also found vancomycin 100% sensitive for MRSA and MSSA and oxacillin 100% resistant for MRSA and 100% sensitive for MSSA. 24 , 25 …”

Section: Discussionmentioning

confidence: 99%

Frequency of nasal carriage of Staphylococcus Aureus among health care workers at a Tertiary Care Hospital

et al. 2018

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Objective:To determine the frequency of Methicillin resistance staphylococcus aureus (MRSA) and identification of drug susceptibility for MRSA isolates among health care workers (HCWs) of a tertiary care hospital of South Punjab Pakistan.Methods:We included 225 HCWs including laboratory staff, doctors, nurses and paramedical staff in this cross-sectional study. The study was conducted in Nishtar medical university/Hospital Multan. The study duration was July-2016 to April-2017. HCWs having no signs of infections and any other systemic disease were included in this study. We used sterile nasal swab sticks for sample collection for determination of S. aureus prevalence. All these samples were processed in the laboratory for MRSA, methicillin sensitive S. aureus (MSSA) and for antimicrobial sensitivity of S. aureus. Chi-square test was used for comparison of frequency of MRSA and MSSA between different HCWs by assuming p-Value ≤0.05 as significant difference.Results:There were 65.3% (147) female participants and only 34.7% (78) male participants. S. aureus was diagnosed in the nasal flora of 24% (54) participants, out of which 9.3% (21) were MRSA positive and remaining 14.7% (33) were MSSA positive. There was no significant difference in frequency of MRSA and MSSA among different HCWs (p-value 0.79). Amikacin and vancomycin were 100% sensitive for MRSA and MSSA. Clindamycin and ciprofloxacin was 80.9% (17) and 71.4% (15) sensitive for MRSA and 100% and 84.8% (28) for MSSA respectively. While oxacillin and Cefoxitin were 100% (21) resistant for MRSA and sensitive for MSSA.Conclusion:Prevalence of MRSA and MSSA is high among HCWs in Pakistan. Amikacin, vancomycin and clindamycin have high sensitivity for MRSA and can be used for empirical treatment of MRSA in suspected patients.

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“…Chloramphenicol, co-trimoxazole and ciprofloxacin were much sensitive drugs in our study with statistical significance (p<0.05). Khatri et al (2017) reported that higher MRSA sensitive to vancomycin followed by co-trimoxazole (84.2%) [24].…”

Section: Discussionmentioning

confidence: 99%

Antibiogram of Biofilm Producing and Non-Producing Community Acquired-Methicillin Resistant Staphylococcus aureus Isolated from Potential Risk Population of Dharan, Nepal

Shakya

Shrestha

Subba

et al. 2019

Preprint

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Background Staphylococcus aureus is one of the common cause of hospital acquired infection and community acquired infections. Nowadays these organisms became resistant towards variety of drugs. MRSA is the emerging antibiotic resistant bacteria that are resistant to methicillin antibiotic and known to be the infectious pathogen causing severe infection and a cause of fatal mortality.Materials and methodology Altogether 200 nasal swabs and 200 hand swabs were obtained from participants and transported to microbiology lab in cold chain. The samples were swabbed in mannitol salt agar (MSA) containing oxacillin powder of 6mg/L and incubated at 37°C for 24 hrs. Staphylococcus aureus colonies were identified based on growth characteristics on MSA plates (golden yellow colonies), Gram stain and positive results for coagulase tube test and catalase test. The pure isolated MRSA were subjected to antibiotic susceptibility tests and biofilm formation assays.Results From our study the overall prevalence of CA-MRSA was 61.5%. Higher frequency of multi-drug resistant MRSA was isolated. The biofilm producing CA-MRSA were 51.2% which showed high drug resistance and rest (48.7%) were non-biofilm producers. There was significant association in biofilm production with multi-drug resistance (p<0.05). Ciprofloxacin was most sensitive drug against the isolates which was statistically significant (p<0.05). The resistant pattern of biofilm producers reported high ability of multi-drug resistance compared to non-biofilm producers (p<0.05). Microtitre plate method was found to be gold standard over tube and congo red agar method for screening biofilm formation. Surprisingly the emergence of VISA and VRSA strains were significantly reported from our study. The prevalence of VISA and VRSA among CA-MRSA was found to be 49.5% and 40.6% respectively among the isolates which indicates the failure of Vancomycin drug in clinical therapy.Conclusions The prevalence of CA-MRSA was found more in barbers followed by beauticians and municipal waste workers in comparison to healthy controls. This study reported the higher carriage of CA-MRSA in potential risk population along with emergence of VISA and VRSA strains. Improvement in personal hygiene and formulation of appropriate health policy helps to prevent CA-MRSA infection. This study concludes that CA-MRSA is still emerging with multi-drug resistance.

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

Cited by 21 publications

References 10 publications

MRSA Strains in Nepalese Rhesus Macaques (Macaca mulatta) and Their Environment

MRSA Strains in Nepalese Rhesus Macaques (Macaca mulatta) and Their Environment

Frequency of nasal carriage of Staphylococcus Aureus among health care workers at a Tertiary Care Hospital

Antibiogram of Biofilm Producing and Non-Producing Community Acquired-Methicillin Resistant Staphylococcus aureus Isolated from Potential Risk Population of Dharan, Nepal

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