Screening of Burns Unit Staff of a Tertiary Care Hospital for Methicillin-Resistant Staphylococcus Aureus Colonisation

Abstract

Staphylococcus aureus is a significant nosocomial pathogen and the development of resistance to methicillin poses a major threat to its control. This study was conducted over a three month period in a Burns Unit of a tertiary care hospital to determine the prevalance of methicillin- resistant S. aureus (MRSA) colonisation in health care workers. All health care workers were screened using swabs from the hairline, nostril, axilla, and hands. Seventeen of 34 health care workers screened were MRSA-positive; 16 people tested positive for the methicillin-sensitive strain of S. aureus, 7 of whom were also MRSA-positive at a different site. In total, over two thirds of all health care workers were colonised by S. aureus. Pus samples from patients admitted in the same unit over the three month study period were analysed and showed that 21% of patients were infected or colonised with MRSA. Although a direct causal relationship is not established by these data, it is reasonable to assume that transmission from colonised health care workers is responsible, at least in part, for the extent of infection/colonisation among patients. These findings identify the need for a well defined policy for screening health care workers and controlling the rates of colonisation with potentially dangerous pathogens given the risk of transmission to susceptible patients.

How often are health care personnel hands colonized with multidrug- resistant organisms? A systematic review and meta-analysis

“…Twenty (33.9%) of the studies were performed after sampling HCP hands on general wards, 38,[42][43][44]47,48,51,55,56,61,67,71,73,74,77,78,85,86,89,92 42,44,46,56,60,[62][63][64]71,72,77,82,85 swab was used in 7 (11.9%), 38,47,49,65,73,75,86 and subungual scraping was used in 1 (1.7%). 61 One study did not specify a collection method.…”

Large retrospective WGS study describes three major sequence types ofS. aureusin India and reveals two novel multi-drug resistant sub-lineages ofS. aureusClonal Complex 22

“…The star-like phylogeny of the 33 isolates indicates the existence of a single contamination source and the absence of person-to-person transmission. One study from India showed that 50% of staff harbored MRSA at any given point (33), which makes it plausible to believe that the single contamination source could be a healthcare professional, as in the case of the MRSA outbreak in Cambridge (34).…”

Novel multidrug-resistant sublineages of Staphylococcus aureus clonal complex 22 discovered in India

“…Reports from the second half of the 1990s show that MRSA was endemic in Indian hospitals, and one study which screened 34 healthcare workers reported that more than 50% of these were found to harbor MRSA at any given point ( 10 , 11 ). The first genotypic study of S. aureus from India, which was conducted between 2003 and 2004 in Bangalore and included 82 isolates ( 12 ) and a typing study of random isolates from the Asian Bacterial Bank collected between 1998 and 2003 both identified international clones sequence type (ST) 239 and ST241 as the major circulating STs in hospitals at the time.…”