METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS CARRIAGE AMONG HEALTH-CARE PROFESSIONALS OF A TERTIARY CARE HOSPITAL

Authors

  • Latha T Assistant Professor, Manipal College of Nursing, Manipal University Manipal, Karnataka, India.
  • Anil K Bhat Department of Orthopedic, Kasturba Medical College, Manipal University Manipal – 576 104, Karnataka, India.
  • Manjunatha Hande H Department of Orthopedic, Kasturba Medical College, Manipal University Manipal – 576 104, Karnataka, India.
  • Chiranjay Mukhopadyay Department of Medicine Kasturba Medical College, Manipal University Manipal, Karnataka, India.
  • Elsa Sanatombi Devi Department of Microbiology, Kasturba Medical College, Manipal University Manipal, Karnataka, India.
  • Baby S Nayak Assistant Professor, Manipal College of Nursing, Manipal University Manipal, Karnataka, India.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i3.23151

Keywords:

Health-care professionals, Methicillin-resistant Staphylococcus aureus (MRSA), colonization, Orthopedics

Abstract

 Objective: The aim of this study was to find the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carrier status in anterior nares and hands of health-care professionals working in orthopedic wards of a tertiary care hospital and to decolonize them to reduce spread of MRSA to their patients.

Methods: The study was conducted in a super specialty, tertiary care teaching hospital. The samples were collected from anterior nares, palm, web spaces, and fingertips of 140 health-care professionals (48 doctors, 74 nurses, and 18 technicians) working in orthopedic wards using sterile pre-moistened swabs. MRSA carrier status was identified by Kirby-Bauer disc diffusion method.

Result: Most (76.4%) of the health-care professionals were <30 years of age and 51% were male. MRSA in anterior nares of doctors was 4.3%, nurses 1.4%, and technicians 0.7% and none had MRSA in their hands. Methicillin-sensitive Staphylococcus aureus (MSSA) growth was more among nurses (nurses - 5.7%, doctors - 2.1%, and technicians - 1.4%) in anterior nares. In addition, 1.4% nurses' hands were colonized with MSSA. Both MRSA and MSSA carriers were decolonized effectively and repeat sampling showed no growth.

Conclusion: Health-care professionals have a greater chance of transmitting MRSA to patients and orthopedic patients are more susceptible for infection. Although MRSA carrier status was not very high among orthopedic health-care professionals compared to previous studies, it cannot be ignored. Nasal mupirocin and bath with chlorhexidine soap were effective in decolonization. Periodic screening and treatment of colonizers would help in elimination of MRSA carriage.

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Author Biographies

Latha T, Assistant Professor, Manipal College of Nursing, Manipal University Manipal, Karnataka, India.

Manipal University, Manipal

Anil K Bhat, Department of Orthopedic, Kasturba Medical College, Manipal University Manipal – 576 104, Karnataka, India.

Department of Orthopedics

Manjunatha Hande H, Department of Orthopedic, Kasturba Medical College, Manipal University Manipal – 576 104, Karnataka, India.

Department of Medicine

Baby S Nayak, Assistant Professor, Manipal College of Nursing, Manipal University Manipal, Karnataka, India.

Department of Microbiology

References

Basak S, Mallick SK, Bose S. Community associated methicillin resistant Staphylococcus aureus (CA-MRSA) - An emerging pathogen: Are we aware? J Clin Diagn Res 2010;4:2111-5.

Lowy FD. Staphylococcus aureus infections. N Engl J Med 1998;339:520-32.

Jevons M. Celbeninâ€-resistant staphylococci. BMJ 1961;1:124-5.

Deotale V, Mendiratta DK, Raut U, Narang P. Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples. Indian J Med Microbiol 2010;28:124-6.

Tiwari HK, Das AK, Sapkota D, Sivarajan K, Pahwa VK. Methicillin resistant Staphylococcus aureus: Prevalence and antibiogram in a tertiary care hospital in western Nepal. J Infect Dev Ctries 2009;3:681-4.

Anderson DJ, Sexton DJ, Kanafani ZA, Auten G, Kaye KS. Severe surgical site infection in community hospitals: Epidemiology, key procedures, and the changing prevalence of methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol 2007;28:1047-53.

Hidron AI, Edwards JR, Patel J, Horan TC, Sievert DM, Pollock DA,et al. NHSN annual update: Antimicrobial-resistant pathogens associated with healthcare-associated infections: Annual summary of data reported to the national healthcare safety network at the centers for disease control and prevention, 2006-2007. Infect Control Hosp Epidemiol 2008;29:996-1011.

Ray P, Gautam V, Singh R. Methicillin-resistant Staphylococcus aureus in developed and developing countries: Implications and solutions. World Health Organization (WHO), special issue on antimicrobial resistance in South-East Asia. Reg Health Forum (WHO South-East Asia region) 2011;15:74-82.

Dar JA, Thoker MA, Khan JA, Ali A, Khan MA, Rizwan M, et al. Molecular epidemiology of clinical and carrier strains of methicillin resistant Staphylococcus aureus (MRSA) in the hospital settings of North India. Ann Clin Microbiol Antimicrob 2006;5:22.

Vonberg PR, Stamm-Balderjahn S, Hansen S, Zuschneid I, Ruden H, Behnke M, et al. How often do asymptomatic health care workers cause methicillin-resistant Staphylococcus aureus outbreaks? A systematic evaluation. Infect Control Hosp Epidemiol 2006;27:1123-7.

Lin YC, Lauderdale TL, Lin HM, Chen PC, Cheng MF, Hsieh KS, et al. An outbreak of methicillin-resistant Staphylococcus aureus infection in patients of a pediatric intensive care unit and high carriage rate among health care workers. J Microbiol Immunol Infect 2007;40:325-34.

Shakya B, Shrestha S, Mitra T. Nasal carriage rate of methicillin resistant Staphylococcus aureus at the national medical college teaching hospital, Birgunj, Nepal. Nepal Med Coll J 2010;12:26-9.

Guleri A, Kehoe A, Hartley J, Lunt B, Harper N, Palmer R, et al. The costs and benefits of hospital MRSA screening. Br J Healthcare Manag 2011;17:64-71.

Solberg CO. Spread of Staphylococcus aureus in hospitals: Causes and prevention. Scand J Infect Dis 2000;32:587-95.

Srinivasan S, Sheela D, Shashikala, Mathew R, Bazroy J, Kanungo R, et al. Risk factors and associated problems in the management of infections with methicillin resistant Staphylococcus aureus. Indian J Med Microbiol 2006;24:182-5.

Rajaduraipandi K, Mani KR, Panneerselvam K, Mani M, Bhaskar M, Manikandan P. Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus: A multicentre study. Indian J Med Microbiol 2006;24:34-8.

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.

Basavaraj CM, Peerapur BV, Jyothi P. Drug resistance patterns of clinical isolates of Staphylococcus aureus in tertiary care center of south India. Int J Pharm Pharm Sci 2015;7:70-2.

Ray P, Singh R. Methicillin-resistant Staphylococcus aureus carriage screening in intensive care. Indian J Crit Care Med 2013;17:205-6.

O’Leary WM. Practical Handbook of Microbiology. Boca Raton, FL: CRC Press; 1989. p. 109-11.

Albrich WC, Harbarth S. Health care workers: Source, vector, or victim of MRSA? Lancet Infect Dis 2008;8:289 301.

Agarwal L, Singh AK, Sengupta C, Agarwal A. Nasal carriage of methicillin- and mupirocin-resistant S. Aureus among health care workers in a tertiary care hospital. J Res Pharm Pract 2015;4:182-6.

Goyal R, Das S, Mathur M. Colonization of methicillin resistant Staphylococcus aureus among health care workers in a tertiary care hospital of Delhi. Indian J Med Sci 2002;56:321-4.

Santhosh DV, Shobha KL, Bairy I, Rao G, Anand KM, D’Souza J. Nasal screening and survey of pre-clinical medical students from Malaysia for nasal carriage of coagulase positive MRSA and rate of nasal colonization with Staphylococcus species. J Clin Diagn Res 2007;1:494-9.

Vinodhkumaradithyaa A, Uma A, Shirivasan M, Ananthalakshmi I, Nallasivam P, Thirumalaikolundusubramanian P, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus among surgical unit staff. Jpn J Infect Dis 2009;62:228-9.

Malini J, Harle SA, Padmavathy M, Umapathy BL, Navaneeth BV, KeerthiMJ, et al. Methicillin-resistant Staphylococcus aureus carriage amongst health care workers in a tertiary care hospital. J Clin Diagn Res 2012;6:791-3.

Radhakrishna M, D’Souza M, Kotigadde S, Saralaya K V, Kotian M S. Prevalence of methicillin resistant Staphylococcus aureus carriage amongst health care workers of critical care units in Kasturba medical college hospital, Mangalore, India. J Clin Diagn Res 2013;7:2697-700.

Renushri BV, Saha A, Nagaraj ER, Rama NK, Krishnamurthy V, Chandrashekar SC. Screening for methicillin-resistant Staphylococcus aureus carriers among individuals exposed and not exposed to the hospital environment and their antimicrobial sensitivity pattern. Ann Trop Med Public Health 2014;7:19-24.

Sharma Y, Jain S, Singh H, Govil V. Staphylococcus aureus: Screening for nasal carriers in a community setting with special reference to MRSA. Scientifica (Cairo) 2014;2014:479048.

Radhakrishna M, Taneja A, Rao P. Nasal carriage of Staphylococcus aureus with special emphasis on methicillin-resistant Staphylococcus aureus among students of a south Indian medical college - Prevalence and antibiogram pattern. Asian J Pharm Clin Res 2016;9 Suppl 2:129-32.

Schito GC. The importance of the development of antibiotic resistance in Staphylococcus aureus. Clin Microbiol Infect 2006;12 Suppl 1:3-8.

Lodise TP Jr., McKinnon PS. Burden of methicillin-resistant Staphylococcus aureus: Focus on clinical and economic outcomes. Pharmacotherapy 2007;27:1001-12.

Edwards C, Counsell A, Boulton C, Moran CG. Early infection after hip fracture surgery: Risk factors, costs and outcome. J Bone Joint Surg Br 2008;90:770-7.

Crum FN, Thornton AS, Stine OC, Wallace RM, Barrozo C, Keefer-Norris, et al. Fifteen-year study of the changing epidemiology of methicillin-resistant Staphylococcus aureus. Am J Med 2006;119:943-51.

Roche S, Fitzgerald D, O’Rourke A, McCabe J. Methicillin-resistant Staphylococcus aureus in an Irish orthopedic center: A five-year analysis. J Bone Joint Surg Br 2006:88:807-11.

Chathurdevi G, Umagowrie S. Potent bioactive metabolites of Casuarina junghuhniana Miq. Roots-a therapeutic approach. Int J Pharm PharmSci 2017;9:158-65.

Published

01-03-2018

How to Cite

T, L., A. K. Bhat, M. H. H, C. Mukhopadyay, E. S. Devi, and B. S. Nayak. “METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS CARRIAGE AMONG HEALTH-CARE PROFESSIONALS OF A TERTIARY CARE HOSPITAL”. Asian Journal of Pharmaceutical and Clinical Research, vol. 11, no. 3, Mar. 2018, pp. 346-9, doi:10.22159/ajpcr.2018.v11i3.23151.

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