Screening of methicillin-resistant Staphylococcus aureus in healthcare workers and students and its susceptibility to mupirocin in a tertiary care teaching hospital in South India (original) (raw)
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Screening of Mupirocin Susceptibility in Carriers of Mrsa Among Healthcare Workers
Background: Methicillin resistant Staphylococcus aureus (MRSA) is a rampant cause of healthcare associated infections(HAI),causing wide range of infections in patients and is mainly spread by asymptomatic nasal carriage in Health care workers(HCWs).The treatment is topical mupirocin which is becoming ineffective owing to acquisition of mupirocin resistance.Therefore their detection in HCWs and the associated mupirocin resistance is necessary. Aim: To find the prevalence of MRSA in nasal swabs taken from HCWs Methods: A nasal swab was collected from the anterior nares of the consenting HCWs. The swabs were then inoculated on basal media and colonies were identified using standard biochemical methods. All Staphylococcus aureus and Coagulase negative Staphylococcus (CoNS) were subjected to disc diffusion method using Cefoxitin (30µg) discs to detect MRSA and MRCoNS. The resistant isolates were tested with mupirocin discs to detect mupirocin resistance. Results: Of 100 HCWs,S.aureus was...
American Journal of Infection Control, 2006
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a serious nosocomial problem, globally distributed. Decolonization with mupirocin can be used to control its dissemination. Objective: To determine the incidence of mupirocin resistance among MRSA carriers from an intensive care unit. Methods: We obtained 2723 nasal swabs during 3 years. Resistance to methicillin and mupirocin were verified (agar diffusion and the E test) and confirmed by polymerase chain reaction (PCR) (mecA for methicillin; ileS-2 and mupA for mupirocin). Plasmidcuring procedure and pulsed-field gel electrophoresis (PFGE) were employed in isolates exhibiting high resistance to mupirocin (HR-Mup) and in other selected organisms. Results: The overall incidence of HR-Mup among MRSA carriers during the studied period was 4.84% (8/165); however, the incidence decreased from 13.04% (6/46) in the first year to 3.5% (2/57) in the second year and was 0% in the last year (P 5 .02). LR-Mup, in contrast, increased significantly (P 5 .01). Conclusion: Plasmid-curing procedure showed the plasmid location of genes responsible for HR-Mup. PFGE demonstrated that most MRSA, including the isolates with HR-Mup, were genetically related. The decline in HR-Mup may be attributable to the plasmid location of genes (ileS-2/mupA) and to the fact that all patients colonized with HR-Mup MRSA died or were discharged in a relatively short period of time.
North American journal of medical sciences, 2014
For the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections and decolonization of MRSA carriers, the use of mupirocin a topical antibiotic is increasing day by day. The present study was carried out to determine the prevalence rate of high-level and low-level mupirocin resistant MRSA isolates among patients admitted to a tertiary care hospital. This is a prospective study carried out on MRSA isolated from the various clinical specimens from outpatient and inpatient departments during period of one year. A total of 82 MRSA isolates were recovered from 6468 different clinical specimens. Mupirocin resistant MRSA was detected by two different methods: Epsilometer test (E-test) and agar dilution method. D-shaped zone test (D-zone test) was also performed for determination of inducible clindamycin resistance in MRSA isolates. Out of 82 non-duplicate MRSA isolates mupirocin resistance were found in 15 (18.3%) isolates by both E-test and agar dilution method. Of these...
IP Innovative Publication Pvt. Ltd., 2017
Introduction: It was observed that Health care workers (HCW) play an important role in the transmission of MRSA between the patients in the hospital environment. The aim of present study was to find out the carriage rate of MRSA among the HCWs in the critical care units in our setting. Material and Method: All healthy HCWs involved in the management of critically ill patients were recruited into the study. By using sterile cotton swabs, specimens were collected from the anterior nares, finger web spaces and finger print directly taken on Brain-Heart infusion agar plate. Staphylococcus aureus was identified by the standard procedure. Antibiotic susceptibility testing was performed according to the Kirby-Bauer disc diffusion method. MRSA was identified by using a cefoxitin disc. Result: Among the 112 HCWs who were screened for MRSA, 54(48.21%) were Nurses and Brothers, 26(23.22%) were nursing students and 32(28.57%) were doctors. Twenty one (18.75%) Staphylococcus aureus strains were isolated. Among them 14 (12.5%) were MRSA. The proportion of nasal carriage of MRSA was higher 9(8.04%) than that on hand 5(4.46%). The highest carriage rate was noted in nurses and brothers (7.14%). Antimicrobial pattern of MRSA had revealed 100% sensitivity to Vancomycin and Linezolid while highest resistance to penicillin, Erythromycin and ciprofloxacin in the present study. Conclusion: MRSA carriage among HCW can be reduce by their regular Screening and decolonization. Strict standard infection control practices should be employed to minimize either the carriage or the transmission rate of MRSA.
Mupirocin-Resistant, Methicillin-Resistant Staphylococcus aureus Strains in Canadian Hospitals
Antimicrobial Agents and Chemotherapy, 2007
This study describes the epidemiology and laboratory characterization of mupirocin-resistant methicillinresistant S. aureus (MRSA) strains in Canadian hospitals. Broth microdilution susceptibility testing of 4,980 MRSA isolates obtained between 1995 and 2004 from 32 Canadian hospitals was done in accordance with CLSI guidelines. The clinical and epidemiologic characteristics of strains with high-level mupirocin resistance (HLMup r ) were compared with those of mupirocin-susceptible (Mup s ) strains. MRSA strains were characterized by pulsed-field gel electrophoresis (PFGE) and typing of the staphylococcal chromosomal cassette mec. PCR was done to detect the presence of the mupA gene. For strains with mupA, plasmid DNA was extracted and subjected to Southern blot hybridization. A total of 198 (4.0%) HLMup r MRSA isolates were identified. The proportion of MRSA strains with HLMup r increased from 1.6% in the first 5 years of surveillance (1995 to 1999) to 7.0% from 2000 to 2004 (P < 0.001). Patients with HLMup r MRSA strains were more likely to have been aboriginal (odds ratio [OR], 3.7; 95% confidence interval [CI], 1.5 to 9.4; P ؍ 0.006), to have had community-associated MRSA (OR, 2.2; 95% CI, 1.0 to 5.0; P ؍ 0.05), and to have been colonized with MRSA (OR, 1.7; 95% CI, 1.0 to 3.0; P ؍ 0.04). HLMup r MRSA strains were also more likely to be resistant to fusidic acid (21% versus 4% for mupirocin-susceptible strains; P < 0.001). All HLMup r MRSA strains had a plasmid-associated mupA gene, most often associated with a 9-kb HindIII fragment. PFGE typing and analysis of the plasmid profiles indicate that both plasmid transmission and the clonal spread of HLMup r MRSA have occurred in Canadian hospitals. These results indicate that the incidence of HLMup r is increasing among Canadian strains of MRSA and that HLMup r MRSA is recovered from patients with distinct clinical and epidemiologic characteristics compared to the characteristics of patents with Mup s MRSA strains.
IP innovative publication pvt. ltd, 2019
Introduction: Carriage of Staphylococcus aureus in the web spaces and anterior nares among the health care workers is a substantial source of human infections. Screening, detection and treatment of such carriers is an important modality in prevention of infections. Colonized health workers especially in teaching hospitals may subsequently develop clinical infections and act as reservoirs for infection among vulnerable individuals. Objectives: Screening of the nursing staff from various departments including critical and non critical areas, identification and speciation of staphylococcus and determining its resistance to cefoxitin and Mupirocin. Materials and Methods: The study was done in the department of Microbiology, Rajarajeswari medical college and hospital, Bangalore, Karnataka. Two swabs were collected from each health care personnel, one swab from anterior nares and other from the web spaces. Swabs were streaked on to blood agar and MacConkey agar plate and incubated at 37◦C for 48hours. Identification done by standard protocols. Susceptibility to cefoxitin and mupirocin was done by Kirby- baeur disc diffusion method. MIC of mupirocin was done E-test method. Results: A total of 200 nursing staff was screened during the study period. Majority of the cultures yielded Coagulase negative staphylococcus followed by no growth from the anterior nares. From the web spaces majority yielded no growth. Out of 78 CONS that were isolated 72 were sensitive to cefoxitin and 8 were resistant. Out of 24 isolated Staphylococcus aureus isolates 20 isolates were sensitive and 4 were resistant to cefoxitin. The MIC values of the four methicillin resistant Staphylococc us aureus were 0.38, 0.25, 0.25, 0.19 which were reported as sensitive strains.
Mupirocin is a topical antibiotic used for nasal decolonisation of methicillin resistant Staphylococcus aureus (MRSA). While resistance to mupirocin has been described it is usually not tested for in most clinical laboratories. Aim: The present study was carried out to detect the occurrence of mupirocin resistance in clinical isolates of Staphylococcus aureus in a tertiary care hospital set up in northern India. Materials and Methods: Staphylococcus aureus isolates obtained from clinical samples received in the microbiology laboratory over a period of one year were included in this study. Mupirocin resistance was detected by three phenotypic methods; disk diffusion method using 5µg and 200µg mupirocin disk to determine low-level and high-level resistance, broth microdilution method and an agar dilution method for determining minimum inhibitory concentrations. Methicillin sensitivity was also determined in the study isolates. Results: Of 250 non-duplicate Staphylococcus aureus isolates obtained, 5 (2%) were found resistant to mupirocin. All mupirocin resistance isolates were shown to have high-level resistance (minimum inhibitory concentration > 512µg/ml). All mupirocin resistant isolates were also resistant to methicillin. Results obtained by all three phenotypic methods showed good correlation. Conclusion: High-level mupirocin resistance is present in the northern Indian population which may be of major concern to prevent the spread of MRSA in hospitals and community.
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.4\_April2021/IJRR-Abstract051.html, 2021
Background and Objectives: Staphylococcus aureus infections especially MRSA infections are an important cause of nosocomial infections worldwide and multidrug resistance is also very commonly seen in these infections. In a healthcare setup, these infections can be acquired through the hands, clothes, and equipments of health care workers. Hence, this study was conducted to see the percentage of MRSA carriage among healthcare workers and to study their antibiotic susceptibility pattern. Materials and Methods: Nasal swabs collected from various categories of Healthcare workers were subjected to processing in the Bacteriology section of Microbiology lab, GMC Jammu. Staphylococcus aureus identification was done according to the standard procedures of the lab. Cefoxitin disc was used for the identification of MRSA strains. Results: A total of 240 volunteers participated in the study. Among the samples screened 38 (16%) were MRSA, 28 (12%) were MSSA. In 172 (72%) no colonization was seen. Highest prevalence of MRSA was seen among Nurses 18 (27%), followed by Laboratory Technicians 10 (15%), Doctors 6 (9%) and Paramedics 4 (6%). Vancomycin and Linezolid were the most sensitive drugs showing 100 % sensitivity. Penicillin was 100 % resistant. Conclusion: A study of MRSA carriage among healthcare workers can help in framing proper and timely antibiotic policies in our hospital which would further stop the emergence of multidrug resistant organism and also guide us in decreasing the prevalence of nosocomial infections.