PDF herunterladen
CC BY-NC-ND 4.0 · J Lab Physicians 2017; 9(04): 317-321
DOI: 10.4103/JLP.JLP_8_17
Original Article

Antimicrobial resistance profile of Methicillin-resistant Staphylococcus aureus colonizing the anterior nares of health-care workers and outpatients attending the remotely located tertiary care hospital of North India

Seema Singh
Department of Microbiology, GGSMC, Faridkot, Punjab, India
,
Rubina Malhotra
Department of Microbiology, GGSMC, Faridkot, Punjab, India
,
Pragati Grover
Department of Microbiology, GGSMC, Faridkot, Punjab, India
,
Renu Bansal
Department of Microbiology, GGSMC, Faridkot, Punjab, India
,
Shipra Galhotra
Department of Microbiology, GGSMC, Faridkot, Punjab, India
,
Rupinderjit Kaur
Department of Microbiology, GGSMC, Faridkot, Punjab, India
,
Neerja Jindal
Department of Microbiology, GGSMC, Faridkot, Punjab, India
› Institutsangaben Financial support and sponsorship: Nil
› Weitere Informationen
Auch verfügbar auf
  als PDF herunterladen Lizenzen und Reprints

Abstract

INTRODUCTION: Resistance to antimicrobial agents is a major concern worldwide and is exemplified by the global spread of the Methicillin resistant Staphylococcus aureus (MRSA). Health care workers (HCWs) and asymptomatically colonized patients are important sources of nosocomial MRSA infections.

AIMS AND OBJECTIVES: To determine the prevalence of MRSA colonisation, two hundred HCWs and 200 consecutive outpatients attending our tertiary care hospital were studied.

MATERIALS AND METHODS: Two sterile pre-moistened cotton tipped swabs were used to collect specimens from their anterior nares. These were inoculated immediately on Blood agar with oxacillin, Mannitol salt agar with oxacillin and CHROM agar. Resistance to cefoxitin was confirmed by PCR by demonstration of mecA gene. Antibiotic susceptibility was determined by Kirby Bauer’s disc diffusion method and MIC of vancomycin by using broth dilution and Vitek-2 Compact system.

RESULTS: The nasal carriage of MRSA among HCWs was found to be 7.5% and in outpatients 3%. All strains of MRSA from HCWs and outpatients grew on three selective media and mecA gene amplified in all of them. All the isolated strains of MRSA showed high degree of resistance to co-trimoxazole (93.3%), ciprofloxacin (80%) and erythromycin (66.66%). However, there was 100% susceptiability to vancomycin, teicoplanin, linezolid and Rifampicin.

CONCLUSION: Although a direct casual relationship could not be established, it could be assumed that the transmission from colonised health care worker is responsible atleast in part for MRSA infection among patients. Therefore emphasis should be laid on strict implementation of standard infection control practices which would help in minimizing the carriage and transmission of MRSA in the hospital.

Key words

mecA - methicillin resistant Staphylococcus aureus - nosocomial


Publikationsverlauf

Artikel online veröffentlicht:
19. Februar 2020

© 2017.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Basak S, Mallick SK, Bose S. Methicillin resistant Staphylococcus aureus (MRSA) infections. J Clin Diagn Res 2010;4:2111-5.
  • 2 MRSA Causes, Symptoms, Treatment-How Common is MRSA? Available from: http://www.emedicine health.com/mrsainfections. [Last accessed on 2015 Sep 22].
  • 3 Indian Network for Surveillance of Antimicrobial Resistance (INSAR) Group, India. Methicillin resistant Staphylococcus aureus (MRSA) in India: Prevalence and susceptibility pattern. Indian J Med Res 2013;137:363-9.
  • 4 Safdar N, Maki DG. The commonality of risk factors for nosocomial colonization and infection with antimicrobial-resistant Staphylococcus aureus, Enterococcus, Gram-negative bacilli, Clostridium difficile, and Candida. Ann Intern Med 2002;136:834-44.
  • 5 Hawkins G, Stewart S, Blatchford O, Reilly J. Should healthcare workers be screened routinely for meticillin-resistant Staphylococcus aureus? A review of the evidence. J Hosp Infect 2011;77:285-9.
  • 6 Eveillard M, Martin Y, Hidri N, Boussougant Y, Joly-Guillou ML. Carriage of methicillin-resistant Staphylococcus aureus among hospital employees: Prevalence, duration, and transmission to households. Infect Control Hosp Epidemiol 2004;25:114-20.
  • 7 Mulqueen J, Cafferty F, Cormican M, Keane JD, Rossney A. Nasal carriage of meticillin-resistant Staphylococcus aureus in GPs in the West of Ireland. Br J Gen Pract 2007;57:811-3.
  • 8 Chang W, Ma X, Gao P, Lv X, Lu H, Chen F. Vancomycin MIC creep in methicillin-resistant Staphylococcus aureus (MRSA) isolates from 2006 to 2010 in a hospital in China. Indian J Med Microbiol 2015;33:262-6.
  • 9 Mathanraj S, Sujatha S, Sivasangeetha K, Parija SC. Screening for methicillin-resistant Staphylococcus aureus carriers among patients and health care workers of a tertiary care hospital in South India. Indian J Med Microbiol 2009;27:62-4.
  • 10 Geha DJ, Uhl JR, Gustaferro CA, Persing DH. Multiplex PCR for identification of methicillin-resistant staphylococci in the clinical laboratory. J Clin Microbiol 1994;32:1768-72.
  • 11 Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Disc Diffusion Tests. Approved Standards. 9th ed. CLSI Document M2-M9. Wayne, PA: Clinical and Laboratory Standards Institute; 2011.
  • 12 Wertheim HF, Melles DC, Vos MC, van Leeuwen W, van Belkum A, Verbrugh HA, et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis 2005;5:751-62.
  • 13 Mulqueen J, Cafferty F, Cormican M, Keane JD, RossneyA. Nasal carriage of MRSA in GPs in the west of Ireland. Br J Gen Pract 2007;57:811-3.
  • 14 Cesur S, Cokça F. Nasal carriage of methicillin-resistant Staphylococcus aureus among hospital staff and outpatients. Infect Control Hosp Epidemiol 2004;25:169-71.
  • 15 Vijaya D, Jankiran K, Sathish JV, Santhosh J. Nasal carriage of MRSA in hospital personnel. J Academy of Clin Microbiol 2011;13:71-6.
  • 16 Shakya B, Shrestha S, Mitra T. Nasal carriage rate of methicillin resistant Staphylococcus aureus among at National Medical College teaching hospital, Birgunj, Nepal. Nepal Med Coll J 2010;12:26-9.
  • 17 Rongpharpi SR, Hazarika NK, Kalita H. The prevalence of nasal carriage of Staphylococcus aureus among healthcare workers at a tertiary care hospital in Assam with special reference to MRSA. J Clin Diagn Res 2013;7:257-60.
  • 18 Shrestha B, Pokhrel BM, Mohapatra TM. Staphylococcus aureus nasal carriage among health care workers in a Nepal Hospital. Braz J Infect Dis 2009;13:322.
  • 19 Vinodhkumaradithyaa A, Uma A, Shirivasan M, Ananthalakshmi I, Nallasivam P, Thirumalaikolundusubramanian P. Nasal carriage of methicillin-resistant Staphylococcus aureus among surgical unit staff. Jpn J Infect Dis 2009;62:228-9.
  • 20 Kalyani K, Jayakumari K, Kumar JS. Prevalence of MRSA among HCWs of Shri Satya Sai Medical College and Hospital - A tertiary care centre. J Dent Med Sci 2012;3:23-7.
  • 21 Golia S, Hittinahalli V, Kamath B, Nirmala AR. A study of nasal carriage of MRSA among the health care workers of a tertiary care hospital, Bangalore. Int J Basic Appl Med Sci 2013;3:3-7.
  • 22 Akoua Koffi C, Dje K, Toure R, Guessennd N, Acho B, Faye Kette H, et al. Nasal carriage of meticillin-resistant Staphylococcus aureus among health care personnel in Abidjan (Côte d'lvoire). Dakar Med 2004;49:70-4.
  • 23 Adwan K, Jarrar N, Abu-Hijleh A, Adwan G, Awwad E, Salameh Y. Molecular analysis and susceptibility patterns of methicillin-resistant Staphylococcus aureus strains causing community-and health care-associated infections in the Northern region of Palestine. Am J Infect Control 2013;41:195-8.
  • 24 Shashikala S. Determination of vancomycin, teichoplanin and linezolid resistance among Staphylococcal isolates from a tertiary care hospital. J Acad Clin Microbiol 2015;17:3-6.
  • 25 Bartlett JG. Methicillin-resistant Staphylococcus aureus infections. Top HIV Med 2008;16:151-5.