Staphylococcus aureus nasal carriage among healthcare workers, inpatients and caretakers in the Tamale Teaching Hospital, Ghana

Walana, Williams; Bobzah, Bernard; Kuugbee, Eugene Dogkotenge; Acquah, Samuel; Vicar, Ezekiel Kofi; Yabasin, Iddrisu Baba; Abdul‐Mumin, Alhassan; Ziem, Juventus B.

doi:10.1016/j.sciaf.2020.e00325

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…The main causes of acute nosocomial infections are medical procedures, bad adherence of patients to prescribed antibiotics, inadequate hospital management and patient health status [ 5 ]. Common sources of infection include germ carriage by medical staff or patients and surface contamination [ 6 ]. The hospital environment provokes the selection and evolution of bacterial clonal lines with increased virulence and multidrug resistance [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Whole-Genome Sequences of Pathogenic Gram-Positive and Gram-Negative Isolates from the Same Hospital Environment to Investigate Common Evolutionary Trends Associated with Horizontal Gene Exchange, Mutations and DNA Methylation Patterning

Korotetskiy¹,

Shilov²,

Kuznetsova³

et al. 2023

Microorganisms

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Hospital-acquired infections are a generally recognized problem for healthcare professionals. Clinical variants of Gram-negative and Gram-positive pathogens are characterized with enhanced antibiotic resistance and virulence due to mutations and the horizontal acquisition of respective genetic determinants. In this study, two Escherichia coli, two Klebsiella pneumoniae, three Pseudomonas aeruginosa, two Staphylococcus aureus, one Staphylococcus epidermidis and one Streptococcus pneumoniae showing broad spectra of antibiotic resistance were isolated from patients suffering from nosocomial infections in a local hospital in Almaty, Kazakhstan. The aim of the study was to compare general and species-specific pathways of the development of virulence and antibiotic resistance through opportunistic pathogens causing hospital-acquired infections. The whole-genome PacBio sequencing of the isolates allowed for the genotyping and identification of antibiotic resistance and virulence genetic determinants located in the chromosomes, plasmids and genomic islands. It was concluded that long-read sequencing is a useful tool for monitoring the epidemiological situation in hospitals. Marker antibiotic resistance mutations common for different microorganisms were identified, which were acquired due to antibiotic-selective pressure in the same clinical environment. The genotyping and identification of strain-specific DNA methylation motifs were found to be promising in estimating the risks associated with hospital infection outbreaks and monitoring the distribution and evolution of nosocomial pathogens.

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Section: Introductionmentioning

confidence: 99%

Analysis of Whole-Genome Sequences of Pathogenic Gram-Positive and Gram-Negative Isolates from the Same Hospital Environment to Investigate Common Evolutionary Trends Associated with Horizontal Gene Exchange, Mutations and DNA Methylation Patterning

Korotetskiy¹,

Shilov²,

Kuznetsova³

et al. 2023

Microorganisms

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“…It was also in agreement with a study conducted by Wangai et al, 2019, that showed the prevalence of MRSA was between 31% and 42% in Uganda.However, the ndings contrast with studies done in Mbale Regional Referral Hospital Eastern, Uganda by(Thembo et al, 2020), that indicated the prevalence of MRSA to be 13.3% among HCWs and patients.The prevalence of MRSA was found to be 31.49% in patients, 29.7% in HCWs, and 28% among patients' caretakers. This correlated with(Ojulong et al, 2008) who conducted a study and indicated the prevalence of MRSA to be 31.5% in patients in Kampala International teaching Hospital, and(Walana et al, 2020) who conducted studies in Ghana that indicated a prevalence of MRSA nasal carriage in Inpatients to be 30.0%, HCWs 27.8% and caretakers 10%.According to the study, antibiotic susceptibility patterns indicated that MRSA was more susceptible to Clindamycin, Ceftaroline, Linezolid, Chloramphenicol, Cipro oxacin and Tetracycline. This was corroborated by(Holmes et al, 2015),(Ojulong et al, 2009) that reported Clindamycin, Ceftaroline, Teicoplanin and Telavancin are effective drugs that can be used to manage MRSA cases.…”

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confidence: 53%

Prevalence of Nasal Carriage of Methicillin Resistant Staphylococcus aureus among Patients, Health Care Workers and Patients’ Care Takers at Kabale Regional Referral Hospital, South Western Uganda

Busingye

Bazira

Musinguzi

et al. 2023

Preprint

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Background Methicillin Resistant Staphylococcus aureus (MRSA) is a type of Gram-positive bacterium that is genetically different from other strains of Staphylococcus aureus by virtue its capability to overcome the actions of methicillin and many other antibiotics making it difficult to treat. MRSA development is as the result of the triggering of the resistance gene, mecA, which react by inhibition of the β-lactams from rendering inactive transpeptidases indispensable in cell wall synthesis. MRSA is one of the known major hospital acquired bacteria that causes severe ill health and mortality world over. The global prevalence of MRSA isolated in swabs samples differs from health care facility to another in various countries, with high rates ranging from 32–52% as reported in low resource settings in the developing countries. In Kabale Regional Referral hospital(KRRH), the prevalence of MRSA stands at 54% among isolates from wound swabs on surgical ward according to studies conducted by Andrew et al., 2016. However, there is hardly any known information of the prevalence of MRSA in nasal swabs of Health care workers (HCWS), patients and patients’ caretakers in KRRH Uganda. This study aimed at ascertaining to the prevalence of nasal carriage of MRSA among HCWs, patients and patients’ caretakers at KRRH. Methods A grand total of 382 samples were collected from the several HCWs, patients and patients’ caretakers in different wards of KRRH in Kabale District. The nasal swab specimens were inoculated and cultivated on Mannitol salt agar at 37°C for 24 hours and the colonies subjected to Gram staining, Catalase, Coagulase test reactions and confirmed as S. aureus bacteria on DNase testing agar. Identification for MRSA was performed using the Cefoxitin (30μg) disc on Mueller Hinton agar medium by disc diffusion technique, antibiotic sensitivity testing was conducted using the Kirby–Bauer disc diffusion method on Mueller–Hinton agar (MHA) and results were interpreted in accordance with Clinical and laboratory standards institute (CLSI) 2020 guidelines. S. aureus mecA and pvl genes were identified and subsequently detected by PCR amplification assay using gene-specific primer pairs to confirm MRSA. Results Out of 382 study participants, 130 participants had MRSA identified phenotypically out of which, 115 of the participants, had MRSA as confirmed by the mec A gene. Generally, the prevalence of nasal carriage of MRSA in Kabale Regional Referral Hospital was found out to be 30.1%. It was found to be 31.49% in patients, 29.7% in HCWs, and 28% among patients’ caretakers. MRSA was highly sensitive/Susceptible to Ceftaroline, Clindamycin, Ciprofloxacin, Linezolid, Chloramphenicol and Tetracycline. Conclusion Generally, the prevalence of nasal carriage of MRSA in the study area was found to be 30.1% and 31.49% in patients, 29.7% in HCWs, and 28% among patients’ caretakers. The highest nasal carriage rate of MRSA was found in patients (31.49%). MRSA was more common in OPD department, followed by medical ward, Gynecology and Obstetrics wards. MRSA strains were sensitive to Ceftaroline, Clindamycin, Ciprofloxacin, Chloramphenicol, Linezolid and Tetracycline. Most of MRSA isolates were multidrug resistant to antibiotics such as Cefoxitin, Sulfamethoxazole-Trimethoprim, and Penicillin.

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“…Generally, we found higher rate of drug resistance for MRSA than MSSA isolates and among HCWs than administrative staff (p-value <0.05), which is in line with other studies. 26 , 32 , 33 This finding underscores that HCWs are exposed to more resistant strains than administrative staff who had no or very limited contact with patients.…”

Section: Discussionmentioning

confidence: 86%

High Levels of Methicillin-Resistant Staphylococcus aureus Carriage Among Healthcare Workers at a Teaching Hospital in Addis Ababa Ethiopia: First Evidence Using mecA Detection

Desta¹,

Aklillu²,

Gebrehiwot³

et al. 2022

IDR

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Background Staphylococcus aureus is a major human pathogen and causes healthcare and community-acquired infection. Data on the extent of MRSA colonization among health-care workers (HCWs) in sub-Saharan Africa are limited. Hence, we determined the burden of MRSA colonisation among HCWs and administrative staff in Tikur Anbessa Specialised Hospital (TASH), College of Health Sciences (CHS), Addis Ababa University, Ethiopia. Methods Using a cross-sectional study design, participants were screened for MRSA colonisation between June 2018 and August 2019 using nasal swabs. The swabs were analysed using standard laboratory methods including antibiotic resistance gene, mecA . Anonymised sociodemographic data were collected by pretested questionnaires to evaluate HCWs factors associated with MRSA carriage. Results A total of 588 HCWs and 468 administrative staff were screened for MRSA. Women were over-represented. Overall, 49.1% (289/588) of HCWs were nurses and 25% (117/468) of the administrative staff were cleaners or laundry workers. Overall, 138 S. aureus isolates were retrieved from the nasal swabs of both groups (16.3%, 96/588 from HCWs). The burden of MRSA colonisation was 4.8% (28/580, 95% CI: 3.1–6.5%) among HCWs compared to 0.2% (1/468, 95% CI: 0.18–0.6%) of administrative staff (p value <0.05). The majority of S. aureus and all MRSA isolates were resistant to penicillin. Isolates from HCWs were more resistant to tested antibiotics than administrative staff (P-value <0.05). Conclusion This is the first report in Ethiopia on MRSA colonization using mecA and revealed that; (i) overall carriage rates of MRSA in HCWs are comparable with observations reported in some other countries and (ii) HCWs exhibit a higher burden of MRSA carriage than administrative staff. Our data support strategic screening of MRSA and antimicrobial stewardship for better intervention measures.

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Staphylococcus aureus nasal carriage among healthcare workers, inpatients and caretakers in the Tamale Teaching Hospital, Ghana

Cited by 6 publications

References 21 publications

Analysis of Whole-Genome Sequences of Pathogenic Gram-Positive and Gram-Negative Isolates from the Same Hospital Environment to Investigate Common Evolutionary Trends Associated with Horizontal Gene Exchange, Mutations and DNA Methylation Patterning

Analysis of Whole-Genome Sequences of Pathogenic Gram-Positive and Gram-Negative Isolates from the Same Hospital Environment to Investigate Common Evolutionary Trends Associated with Horizontal Gene Exchange, Mutations and DNA Methylation Patterning

Prevalence of Nasal Carriage of Methicillin Resistant Staphylococcus aureus among Patients, Health Care Workers and Patients’ Care Takers at Kabale Regional Referral Hospital, South Western Uganda

High Levels of Methicillin-Resistant Staphylococcus aureus Carriage Among Healthcare Workers at a Teaching Hospital in Addis Ababa Ethiopia: First Evidence Using mecA Detection

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