COMPARISON OF NASAL CARRIAGE OF MRSA AND ITS ANTIBIOTIC SUSCEPTIBILITY WITH SPECIAL REFERENCE TO MUPIROCIN AMONG STUDENTS OF HEALTH-CARE SETTINGS AND OTHER STUDENTS
DOI:
https://doi.org/10.22159/ajpcr.2024.v17i3.49443Keywords:
Nasal carriage, Methicillin-resistant Staphylococcus aureus, Mannitol salt agar, Disc diffusion technique, Community acquired methicillin resistant Staphylococcus aureus, Mupirocin discAbstract
Objectives: One of the potential risk factors for nosocomial staphylococcal and Methicillin-resistant Staphylococcus aureus (MRSA) infections is colonization of the anterior nares of HCWs, and from there they may spread to the patients, which may cause a burden on the health-care system. In this context, we made an attempt to compare the Staphylococcal and MRSA nasal carriage and their susceptibility to Mupirocin in students who are exposed to the health-care system and those who are not.
Methods: Nasal swabs were collected from 100 paramedical students as the study group and 100 non-medical students as the control group, all in the age group between 18 and 21 years. 5% sheep blood agar and mannitol salt agar were used to isolate S. aureus, and antibiotic sensitivity was done by Kirby Bauer Disc Diffusion Technique. Cefoxitin disc (30 μg) and Vancomycin screen agar were used to detect MRSA and Vancomycin resistance, respectively. A 5 μg disc of Mupirocin was used to test the susceptibility of Mupirocin.
Results: Nasal carriage rate of S. aureus and MRSA was 23% and 8% in Paramedical students and 17% and 4% in Nonmedical students respectively. 83% of isolates from paraclinical students and 95% of isolates from non-medical students were susceptible to linezolid. Out of 12 MRSA strains from both groups only one strain showed resistance to Mupirocin.
Conclusions: Nasal carriage of S. aureus and MRSA and antibiotic resistance of isolated strains were more common in paramedical students and also in female students. Vancomycin resistance was not observed in MRSA strains from male students. Mupirocin resistance, even in a single case, needs to be addressed.
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References
Majumdar D, Barua A, Paul B. Nasal carriage of methicillin resistant Staphylococci in healthy population of east Sikkim. Indian J Commun Med 2009;34:364-5. doi: 10.4103/0970-0218.58403
Giri N, Maharjan S, Thapa TB, Pokhrel S, Joshi G, Shrestha O, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus among healthcare workers in a tertiary care hospital, Kathmandu, Nepal. Int J Microbiol 2021;2021:8825746. doi: 10.1155/2021/8825746
Agarwal L, Singh AK, Sengupta C, Agarwal A. Nasal carriage of methicillin- and Mupirocin-resistant S. aureus among health care workers in a tertiary hospital. J Res Pharm Pract 2015;4:182-6. doi: 10.4103/2279-042X.167046
Chaturvedi P, Singh AK, Singh AK, Shukla S, Agarwal L. Prevalence of mupirocin resistant Staphylococcus aureus isolates among patients admitted to a tertiary care hospital. N Am J Med Sci 2014;6:403-7. doi: 10.4103/1947-2714.139293
CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard-Eleventh Edition and Performance Standards for Antimicrobial Susceptibility Testing: Twenty- Third Informational Supplement. CLSI Document M02-A11 and M100-S23. Wayne, PA: Clinical and Laboratory Standard Institute; 2013.
Tiwari HK, Sen MR. Emergence of vancomycin resistant Staphylococcus aureus (VRSA) from a tertiary care hospital from northern part of India. BMC Infect Dis 2006;6:156. doi:10.1186/1471-2334-6-156
Shivanna V, Kumar RN, Venkatesha D. The emergence of Mupirocin resistance among the clinical isolates of Staphylococci in a rural tertiary health-care centre of South India. J Acad Clin Microbiol 2018;20:14-8.
Greenwood D, Slack RC, Barer MR, Irving WL, editors. Medical Microbiology: A Guide to Microbial Infections. 18th ed. London: Churchill Livingston Elsevier; 2012.
Poovelikunnel T, Gethin G, Humphrey H. Mupirocin resistance: Clinical implications and potential alternatives for the eradication of MRSA. J Antimicrob Chemother 2015;70:2681-92. doi:10.1093/jac/ dkv169
Procop GW, Church DL, Hall GS, Janda WM, Koneman EW, Schreckenberger PC, et al. Koneman’s Color Atlas and Text Book of Diagnostic Microbiology. 7th ed. China: Wolters Kluwer Publishers; 2017.
Patel JB, Gorwitz RJ, Jernigan JA. Mupirocin resistance. Clin Infect Dis 2009;49:935-41.
Dadashi M, Hajikhani B, Darban-Sarokhalil D, Belkum A, Goudarzi M. Mupirocin resistance in Staphylococcus aureus: A systematic review and meta-analysis. J Glob Antimicrob Resist 2020;20:238-47. doi: 10.1016/j.jgar.2019.07.032
Bharathi M, Padmaja IJ. A study on nasal carriage of MRSA and its antimicrobial susceptibility pattern in healthy individuals and hospitalised patients. J Evol Med Dent Sci 2012;1:302-7.
Pires FV, de Souza da Cunha ML, Abraão LM, Martins PY, Camargo CH, Fortaleza CM. Nasal carriage of Staphylococcus aureus in Botucatu, Brazil: A population-based survey. PLoS One 2014;9:e92537.
Anwar MS, Jaffery G, Rehman Bhatti KU, Tayyib M, Bokhari SR. Staphylococcus aureus and MRSA nasal carriage in general population. J Coll Phys Surg Pak 2004;14:661-4.
Choi CS, Yin CS, Bakar AA, Sakewi Z, Naing NN, Jamal F, et al. Nasal carriage of Staphylococcus aureus among healthy adults. J Microbiol Immunol Infect 2006;39:458-64.
Fomda BA, Thokar MA, Khan A, Bhat JA, Zohoor D, Bashir G, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus among healthy population of Kashmir, India. Indian J Med Microbiol 2015;33:469.
Ahmadi E, Khojasteh M, Mortazavi SM, Khan-Mohammadi F, Kazemnia A, Beheshtipour J, et al. Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus nasal carriage in the West of Iran: A population-based cross-sectional study. BMC Infect Dis 2019;19:899.
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;9:129-32.
Lally RT, Lanz E, Schrock CG. Rapid control of an outbreak of Staphylococcus aureus on a neonatal intensive care department using standard infection control practices and nasal mupirocin. Am J Infect Control 2004;32:44-7.
Mohajeri P, Gholamine B, Rezaei M, Khamisabadi Y. Frequency of mupirocin resistant Staphylococcus aureus strains isolated from nasal carriers in hospital patients in Kermanshah. Jundishapur J Microbiol 2012;5:560-3. doi: 10.5812/jjm.4199
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