scholarly journals Methicillin-resistant Staphylococcus aureus nasal colonization among HIV-infected patients in Taiwan: prevalence, molecular characteristics and associated factors with nasal carriage

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yi-Yu Hsu ◽  
David Wu ◽  
Chien-Ching Hung ◽  
Shie-Shian Huang ◽  
Fang-Hsueh Yuan ◽  
...  
2019 ◽  
Author(s):  
Nobert Thembo ◽  
George Masifa ◽  
Gerald Kamugisha ◽  
Robinah Nabitaka ◽  
Benjamin Akais ◽  
...  

Abstract Background: Asymptomatic carriage of Methicillin-Resistant Staphylococcus aureus (MRSA) can predispose the host to a wide array of infections that can be difficult to treat due to antibiotic resistance. To inform public health strategies, the study sought to describe MRSA nasal carriage frequencies and the associated factors concerning nasal carriage among patients attending Mbale Regional Referral Hospital (MRRH). Methods: Nasal swabs were obtained from consented (aged >15years) participants presenting to the hospital for medical care between January and April 2018[L1] . Direct Culture of swabs was performed on blood agar and then incubated at 37℃ for 24 hours. Identification of S. aureus was done using conventional biochemical tests. Phenotypic screening and confirmation of MRSA was done using cefoxitin disc (30µg) test and MICs on the Phoenix M50 instrument respectively. Patient demographic characteristics and the MRSA nasal carriage risk factors were collected using a pre-tested questionnaire. Results: Overall, majority of the participants were in-patients (138, 63.3%) with the proportions of both females and males among the participants being 154/218 (70.6%) and 64/218 (29.3%) respectively. Mean age for both female and male participants was 40.16 (SD± 17.04) years respectively. S. aureus nasal carriage rate among the participants was 22.9% (50/218), with 57.9% (29/50) of the harboured strains phenotypically expressing methicillin resistance (mecA mediated). Phenotypic co-expression with inducible clindamycin resistance and vancomycin resistance was displayed in 45.5% (23/50) and 2% (1/50) of the studied isolates respectively. Colonisation with MRSA did not show any significant relationship with all the studied factors. Conclusion: There was a moderate S. aureus nasal carriage among the participants in Mbale Regional Referral Hospital with a highly noted phenotypic expression of methicillin resistance among the isolated S. aureus strains. The studied factors were not significantly associated with the rate of MRSA nasal carriage. For surveillance purposes to combat future outbreaks, there is a need to do a larger study to better draw generalizable conclusions of carriage in the population. [L1]This is an important statement. I suggest that we reinstatate it if we are still in recommended word count


2020 ◽  
Author(s):  
Yi-Yu Hsu ◽  
David Wu ◽  
Chien-Ching Hung ◽  
Shie-Shian Huang ◽  
Fang-Hsueh Yuan ◽  
...  

Abstract Objective To evaluate nasal carriage, antibiotic susceptibility and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA), as well as the risk factors of MRSA colonization, in human immunodeficiency virus (HIV)-infected patients in northern Taiwan. Methods From September 2014 to November 2015, HIV-infected patients seeking outpatient care at four hospitals were eligible for this study. A nasal specimen was obtained from each subject for the detection of S. aureus and a questionnaire was completed by each subject. MRSA isolates once identified were characterized. Results Of 553 patients surveyed, methicillin-susceptible S. aureus (MSSA) was detected in 119 subjects (21.5%) and MRSA in 19 subjects (3.4%). Female gender, injection drug use, smoking, hepatitis C virus carrier, cancer and antibiotic use within one year were positively associated with MRSA colonization. By multivariate analysis, only cancer (adjust odds ratio (aOR) 7.78, [95% confidence interval (CI), 1.909-31.731]) and antibiotic use within one year (aOR 3.89, [95% CI, 1.219-12.433]) were significantly associated with MRSA colonization. Ten isolates were characterized as sequence type (ST) 59/staphylococcal chromosome cassette (SCC) IV or V T , endemic community strains in Taiwan, four isolates as ST 8/SCC mec IV (USA 300) and one isolate as ST 239/SCC mec IIIA, a hospital strain. All the community-associated MRSA isolates were susceptible to trimethoprim-sulfamethoxazole (TMP-SMX). Conclusions Nasal MRSA carriage in HIV-infected patients seeking outpatient care was low (3.4%) in northern Taiwan. Most of the colonizing isolates were genetically endemic community strains and exhibited high susceptibility to TMP-SMX and fluoroqinolones. Cancer and antibiotic use within one year were associated with MRSA colonization.


2020 ◽  
Author(s):  
Seid Abie ◽  
Moges Tiruneh ◽  
Wondwossen Abebe

Abstract Background: Nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA) plays a key role in the epidemiology and pathogenesis of both healthcare-associated and community-acquired MRSA infections in various populations. Screening of MRSA nasal colonization is important in the prevention and control of infection and may provide useful information to guide antimicrobial therapy. This study aimed to determine nasal carriage of MRSA, its antimicrobial susceptibility pattern, and associated factors among janitors working in hospital & non-hospital areas at the University of Gondar, Northwest Ethiopia.Methods: A comparative cross-sectional study was carried out in a total of 436 study participants (221 hospital and 215 non-hospital janitors) from January to May 2019. The study participants were sampled using a simple random sampling technique. Data on socio-demographic characteristics and associated factors were collected through face to face interviews using a structured questionnaire. Nasal swabs were collected and inoculated into Mannitol salt agar. MRSA was detected using cefoxitin (30µg) disc and an antibiotic susceptibility test was done using the disc diffusion method. Data were entered and analyzed using SPSS version 20 statistical package. P-value ≤ 0.05 was considered as statistically significant.Results: The overall prevalence of S. aureus was 101/436 (23.2%, [95% CI: 19.3-27.8], of which, 29.4% (65/221) were isolated from hospital and 16.7% (36/215) non-hospital janitors. The prevalence of MRSA was 4.8% (21/436) [95% CI: 3.0-6.9]; of these, 8.1% (18/221) of the isolates were from the hospital and 1.4% (3/215) non-hospital janitors, while MSSA in hospital & non-hospital janitors were 49 (22.2%) and 31 (14.4%), respectively. Among the MRSA isolates, 52.4% (11/21) were multi-drug resistant. Of these, 42.9% (9/18) were isolated from hospital and 66.7% (2/3) non-hospital janitors. Hence, nasal carriage of MRSA was significantly associated with hospitalization within the preceding year (AOR = 3.15, CI = 1.13-8.71).Conclusion: The present study revealed that high MSSA and MRSA were isolated from the hospital as compared to non-hospital janitors and high rates of antibiotics resistance were recorded in the hospital janitors. Consequently, hospitalizations were significantly associated with MRSA. Accordingly, regular screening of carriers in apparently healthy janitors is required for the prevention of nosocomial infections.


2020 ◽  
Author(s):  
Seid Abie ◽  
Moges Tiruneh ◽  
Wondwossen Abebe

Abstract Background: Nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA) plays a key role in the epidemiology and pathogenesis of both healthcare-associated and community-acquired MRSA infections in various populations. Screening of MRSA nasal colonization is important in the prevention and control of infection and may provide useful information to guide antimicrobial therapy. This study aimed to determine nasal carriage of MRSA, its antimicrobial susceptibility pattern, and associated factors among janitors working in hospital & non-hospital areas at the University of Gondar, Northwest Ethiopia.Methods: A comparative cross-sectional study was carried out in a total of 436 study participants (221 hospital and 215 non-hospital janitors) from January to May 2019. The study participants were sampled using a simple random sampling technique. Data on socio-demographic characteristics and associated factors were collected through face to face interviews using a structured questionnaire. Nasal swabs were collected and inoculated into Mannitol salt agar. MRSA was detected using cefoxitin (30µg) disc and an antibiotic susceptibility test was done using the disc diffusion method. Data were entered and analyzed using SPSS version 20 statistical package. P-value ≤ 0.05 was considered as statistically significant.Results: The overall prevalence of S. aureus was 101/436 (23.2%, [95% CI: 19.3-27.8], of which, 29.4% (65/221) were isolated from hospital and 16.7% (36/215) non-hospital janitors. The prevalence of MRSA was 4.8% (21/436) [95% CI: 3.0-6.9]; of these, 8.1% (18/221) of the isolates were from the hospital and 1.4% (3/215) non-hospital janitors, while methicillin-sensitive S. aureus (MSSA) in hospital & non-hospital janitors were 49 (22.2%) and 31 (14.4%), respectively. Among the MRSA isolates, 52.4% (11/21) were multi-drug resistant. Of these, 42.9% (9/18) were isolated from hospital and 66.7% (2/3) non-hospital janitors. Hence, nasal carriage of MRSA was significantly associated with hospitalization within the preceding year (AOR = 3.15, CI = 1.13-8.71).Conclusion: The present study revealed that high MSSA and MRSA were isolated from the hospital as compared to non-hospital janitors and high rates of antibiotics resistance were recorded in the hospital janitors. Consequently, hospitalizations were significantly associated with MRSA. Accordingly, regular screening of carriers in apparently healthy janitors is required for the prevention of nosocomial infections.


2019 ◽  
Author(s):  
Yingying Wang ◽  
Jialing Lin ◽  
Junli Zhou ◽  
Zhigang Han ◽  
Zhenjiang Yao

Abstract Background: Staphylococcus aureus ( S. aureus ) and methicillin-resistant Staphylococcus aureus (MRSA) remained the predominant cause of infections in drug users. The cross-sectional study aimed to elucidate the prevalence, risk factors, phenotypic and molecular characteristics of S. aureus and MRSA carriage among community-based drug users. Methods: Eligible drug users were asked to complete questionnaires and collect nasal swabs during May and December 2017 in Guangzhou, China. Swabs were processed for identification of S. aureus and MRSA. Antimicrobial susceptibility test and polymerase chain reaction assays were used to detect phenotypic and molecular characteristics for identified isolates. Univariate and multivariate logistic regression analyses were used to assess risk factors for S. aureus and MRSA carriage. Results: Overall, the prevalence of S. aureus and MRSA carriage in 353 drug users were 15.01% and 6.79%, respectively. Cohabitation was a risk factor for S. aureus (adjusted OR=8.80, 95% CI: 1.89-40.99) and MRSA (adjusted OR=14.30, 95% CI: 2.67-76.46) carriage. The proportions of multidrug resistance were respectively 72.41% and 89.47% for S. aureus and MRSA isolates and were simultaneously resistant to penicillin, erythromycin and clindamycin. The results of clonal complexes and sequence types for S. aureus and MRSA isolates were diverse. The proportions of virulence genes were high for MRSA isolates. Conclusion: The prevalence of S. aureus nasal carriage was lower while the prevalence of MRSA nasal carriage was moderate. Phenotypic and molecular characteristics of MRSA isolates revealed serious antibiotic resistance, indicating the cross-circulation of MRSA isolates, and imply high opportunity of virulence-related diseases. Decolonization might be considered for drug users with MRSA carriage, especially for those with risk factors.


2020 ◽  
Author(s):  
Nobert Thembo ◽  
George Masifa ◽  
Gerald Kamugisha ◽  
Robinah Nabitaka ◽  
Benjamin Akais ◽  
...  

Abstract Background: Asymptomatic carriage of Methicillin-Resistant Staphylococcus aureus (MRSA) can predispose the host to a wide array of infections that can be difficult to treat due to antibiotic resistance. To inform public health strategies, the study sought to describe MRSA nasal carriage frequencies and the associated factors concerning nasal carriage among patients attending Mbale Regional Referral Hospital (MRRH). Methods: Nasal swabs were obtained from consented (aged >15years) participants presenting to the hospital for medical care between January and April 2018 [L1] . Direct Culture of swabs was performed on blood agar and then incubated at 37℃ for 24 hours. Identification of S. aureus was done using conventional biochemical tests. Phenotypic screening and confirmation of MRSA was done using cefoxitin disc (30µg) test and MICs on the Phoenix M50 instrument respectively. Patient demographic characteristics and the MRSA nasal carriage risk factors were collected using a pre-tested questionnaire. Results: Overall, majority of the participants were in-patients (138, 63.3%) with the proportions of both females and males among the participants being 154/218 (70.6%) and 64/218 (29.3%) respectively. Mean age for both female and male participants was 40.16 (SD± 17.04) years respectively. S . aureus nasal carriage rate among the participants was 22.9% (50/218), with 57.9% (29/50) of the harboured strains phenotypically expressing methicillin resistance ( mecA mediated). Phenotypic co-expression with i nducible clindamycin resistance and vancomycin resistance was displayed in 45.5% (23/50) and 2% (1/50) of the studied isolates respectively. Colonisation with MRSA did not show any significant relationship with all the studied factors. Conclusion : There was a moderate S. aureus nasal carriage among the participants in Mbale Regional Referral Hospital with a highly noted phenotypic expression of methicillin resistance among the isolated S. aureus strains. The studied factors were not significantly associated with the rate of MRSA nasal carriage. For surveillance purposes to combat future outbreaks, there is a need to do a larger study to better draw generalizable conclusions of carriage in the population. [L1] This is an important statement. I suggest that we reinstatate it if we are still in recommended word count


2019 ◽  
Author(s):  
Nobert Thembo ◽  
George Masifa ◽  
Gerald Kamugisha ◽  
Robinah Nabitaka ◽  
Benjamin Akais ◽  
...  

Abstract Background: Asymptomatic carriage of Methicillin-Resistant Staphylococcus aureus (MRSA) can predispose the host to a wide array of infections that would pose a challenge in the management of the cases in a current era encompassed with antibiotic resistance. To inform public health strategies, the study sought to describe MRSA nasal carriage frequencies and the associated factors concerning nasal carriage among patients attending Mbale Regional Referral Hospital (MRRH). Methods: Two hundred eighteen consented participants presenting to the hospital for medical care between January and April 2018 were recruited to participate in this study. Sampling was done on both anterior nares using a pre-moistened swab and then transported to the laboratory at Room temperature for the detection of MRSA. Culture was performed on blood agar and plates incubated at 37℃ for 24 hours. Identification of Staphylococcus aureus was done using conventional biochemical tests . MRSA was detected phenotypically using cefoxitin (30µg) as a surrogate test as per the Clinical Laboratory Standard Institute guidelines 2017 version. Patient demographic characteristics and the MRSA nasal carriage factors were collected using a pre-tested questionnaire. The collected raw data was entered into excel and later imported into STATA software for analysis. Results: Overall, Majority of the participants were in-patients (138, 63.3%) with the proportions of both females and males among the participants being 154/218 (70.6%) and 64/218 (29.3%) respectively. Mean age for both female and male participants was 40.16 (SD± 17.04) years respectively. Staphylococcus aureus nasal carriage rate among the participants was 22.9% (50/218), with 72% (36/50) of the harboured strains phenotypically expressing methicillin resistance. Colonization with Methicillin Resistant Staphylococcus aureus did not show any significant relationship with all the studied factors. Conclusion: There was a moderate Staphylococcus aureus nasal carriage among the participants in Mbale Regional Referral Hospital. We also observed a highly displayed phenotypic expression of methicillin resistance among the isolated Staphylococcus aureus strains. The studied factors indicated an independent influence on the rate of nasal carriage. For surveillance purposes to combat future outbreaks, there is a need to do a larger study with better power to better draw generalizable conclusions of carriage in the population.


Author(s):  
Seid Abie ◽  
Moges Tiruneh ◽  
Wondwossen Abebe

Abstract Background Nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA) plays a key role in the epidemiology and pathogenesis of both healthcare-associated and community-acquired MRSA infections in various populations. Screening of MRSA nasal colonization is important in the prevention and control of infection and may provide useful information to guide antimicrobial therapy. This study aimed to determine nasal carriage of MRSA, its antimicrobial susceptibility pattern, and associated factors among janitors working in hospital & non-hospital areas at the University of Gondar, Northwest Ethiopia. Methods A comparative cross-sectional study was carried out in a total of 436 study participants (221 hospital and 215 non-hospital janitors) from January to May 2019. The study participants were sampled using a simple random sampling technique. Data on socio-demographic characteristics and associated factors were collected through face to face interviews using a structured questionnaire. Nasal swabs were collected and inoculated into Mannitol salt agar. MRSA was detected using cefoxitin (30 µg) disc and an antibiotic susceptibility test was done using the disc diffusion method. Data were entered and analyzed using SPSS version 20 statistical package. P value ≤ 0.05 was considered as statistically significant. Results The overall prevalence of S. aureus was 101/436 [23.2%, (95% CI: 19.3–27.8)], of which, 29.4% (65/221) were isolated from hospital and 16.7% (36/215) non-hospital janitors. The prevalence of MRSA was 4.8% (21/436) [95% CI: 3.0–6.9]; of these, 8.1% (18/221) of the isolates were from the hospital and 1.4% (3/215) non-hospital janitors, while methicillin-sensitive S. aureus (MSSA) in hospital & non-hospital janitors were 49 (22.2%) and 31 (14.4%), respectively. Among the MRSA isolates, 52.4% (11/21) were multi-drug resistant. Of these, 42.9% (9/18) were isolated from hospital and 66.7% (2/3) non-hospital janitors. Hence, nasal carriage of MRSA was significantly associated with hospitalization within the preceding year (AOR = 3.15, CI = 1.13–8.71). Conclusion The present study revealed that high MSSA and MRSA were isolated from the hospital as compared to non-hospital janitors and high rates of antibiotics resistance were recorded in the hospital janitors. Consequently, hospitalizations were significantly associated with MRSA. Accordingly, regular screening of carriers in apparently healthy janitors is required for the prevention of nosocomial infections.


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