scholarly journals A study of nasal carriage of methicillin-resistant staphylococcus aureus in patients undergoing hemodialysis in a tertiary care hospital of Punjab

2021 ◽  
Vol 8 (10) ◽  
pp. 4933
Author(s):  
Prabhjot Singh Dhillon ◽  
Vishal Sharma ◽  
Manpreet Kaur Brar ◽  
Durgesh Thakur ◽  
Rupali Rishu ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Susceptibility Testing ◽  
Methicillin Resistance ◽  
Nasal Carriage ◽  
Hemodialysis Patients ◽  
Healthy Population ◽  
Carrier Status ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Increased Risk

Background: Infection is one of the major problems encountered in hemodialysis patients. The mortality rate among the patients undergoing hemodialysis remains unsatisfactorily high. Hemodialysis patients have higher nasal carriage rate of Staphylococcus aureus than the healthy population. In long-term hemodialysis patients, colonization is a significant problem and is associated with an increased risk of the bloodstream infections. The antimicrobial resistance to this pathogen is increasing rapidly, and the consequences of methicillin resistance for the outcomes of Staphylococcus aureus infections are drastic.Methods: Two swabs were collected from anterior nares of patients undergoing hemodialysis, and then these swabs were transferred to microbiology laboratory for processing. Isolated strains were subjected to antimicrobial susceptibility testing using Kirby-Bauer disc diffusion. Methicillin resistance was detected by using cefoxitin disc. Inhibition zone diameters were measured as per CLSI criteria. Vancomycin screen agar test was done. Brain heart infusion agar plates containing 6 µg/ml of vancomycin were used. S. aureus ATCC 29213 was used as reference strain.Results: It was observed that 38% (38/100) of the hemodialysis patients were carriers of S. aureus followed by CoNS, followed by aerobic spore bearers. All the S. aureus isolates (100%, 38/38) were methicillin-resistant (MRSA).Conclusions: Staphylococcal nasal carrier status in hemodialysis patients along with antibiotic susceptibility testing should be done in routine and infection control practices should be followed to prevent the transmission of MRSA among chronic hemodialysis patients.

scholarly journals Resistance pattern of methicillin resistant Staphylococcus aureus among nasal isolates of HIV infected patients in a tertiary care hospital

2019 ◽  
Vol 7 (2) ◽  
pp. 428
Author(s):  
Manish Kumar Diwakar ◽  
Ankur Goyal ◽  
Sapna Goyal
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Meca Gene ◽  
Nasal Carriage ◽  
Control Group ◽  
Care Hospital ◽  
Disc Diffusion ◽  
Increased Risk ◽  
Nasal Swab Sample

Background: Patients infected with HIV have an increased risk of nasal Staphylococcus aureus carriage as well as consecutive staphylococcal infections and is a major reservoir for MRSA which is potential risk factors for community acquired MRSA. Knowing the Nasal carriage status of Staphylococcus aureus and their Antibiogram will be beneficial for effective management of these patients.Methods: Nasal swab sample were collected from all the participants and processed for culture and identification of Staphylococcus aureus and their antimicrobial sensitivity. All the Staphylococcus aureus isolates were tested for Methicillin resistance by Oxacillin screen agar test, cefoxitin disc diffusion test and further confirmed by mecA gene PCR.Results: In this study out of 220 HIV seropositive patients, 43.64% isolates were confirmed to be S. aureus, 18.75% MRSA and 81.25% were MSSA. Cefoxitin disc diffusion showed 100% specificity (95% CI; 97.05%-100.00%), 100% sensitivity (95% CI; 83.89-100.00%) and 100% accuracy (95% CI; 97.47% to 100.00%) while comparing with gold standard mecA gene PCR. Among the nasal carriers; males (60%) ware dominant on females (40%). 31-50 years age group was strongly associated with MRSA nasal carriage. None of the isolates were resistant against lenozolid, teicoplanin and vancomycin while ampicillin (75%), ciprofloxacin (62.5%), clindamycin (59.38%) and cotrimoxazole (53.13%) showed increased resistance against S. aureus nasal carriage.Conclusions: Resistance among HIV positive persons for all antibiotics showed statistically significant while compared to control group. Cefoxitin disc diffusion can be used as surrogate agent for mecA gene detection.

scholarly journals Staphylococcus aureus with inducible clindamycin resistance and methicillin resistance in a tertiary hospital in Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Devi Thapa ◽  
Susil Pyakurel ◽  
Sabita Thapa ◽  
Suresh Lamsal ◽  
Mahesh Chaudhari ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Methicillin Resistance ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Antibiotic Susceptibility Testing ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance

Abstract Background Staphylococcus aureus is a global public health issue in both community and hospital settings. Management of methicillin-resistant S. aureus (MRSA) infections are tough owing to its resistance to many antibiotics. Macrolide-lincosamide-streptogramin B (MLSB) antibiotics are commonly used for the management of MRSA. This study was aimed to determine the occurrence of inducible clindamycin- and methicillin-resistant S. aureus at a tertiary care hospital in Kathmandu, Nepal. Methods A total of 1027 clinical samples were processed following standard laboratory procedures and antibiotic susceptibility testing of S. aureus was performed by disc diffusion method. MRSA isolates were detected phenotypically using cefoxitin disc, and inducible clindamycin resistance was detected phenotypically using the D-zone test. Results Of 1027 samples, 321 (31.2%) were culture positive, of which 38 (11.8%) were S. aureus. All S. aureus isolates were susceptible to vancomycin, and 25 (67%) of S. aureus isolates were multidrug-resistant. Similarly, 15 (39.5%) of S. aureus were MRSA and 14 (36.5%) were inducible clindamycin-resistant phenotypes. Conclusion Inducible clindamycin and methicillin resistance were common in S. aureus. This emphasizes that the methicillin resistance test and the D-zone test should be incorporated into the routine antibiotic susceptibility testing in hospital settings.

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

2018 ◽  
Vol 11 (3) ◽  
pp. 346
Author(s):  
Latha T ◽  
Anil K Bhat ◽  
Manjunatha Hande H ◽  
Chiranjay Mukhopadyay ◽  
Elsa Sanatombi Devi ◽  
...  
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Health Care Professionals ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Carrier Status ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Orthopedic Patients

 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.

scholarly journals IS ACQUISITION OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS - AN OCCUPATIONAL HAZARD FOR MEDICAL STUDENTS IN INDIA?

2017 ◽  
Vol 10 (12) ◽  
pp. 141 ◽  
Author(s):  
Shreyas K ◽  
Radhakrishna M ◽  
Ashwini Hegde ◽  
Pooja Rao
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Students ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Nasal Carriage ◽  
Occupational Hazard ◽  
Carriage Rate ◽  
Methicillin Resistant ◽  
Drug Resistant Strains ◽  
Hospital Acquired

  Objective: The incidence of community-acquired and hospital-acquired Staphylococcus aureus infections has been rising with increasing emergence of drug-resistant strains called methicillin-resistant S. aureus (MRSA). The main objective of this study was to determine the prevalence of carriage rate of MRSA among the interns of tertiary care teaching hospital in Mangalore.Methods: A total of 150 interns were participated, thereby swabs from both anterior nares were collected and processed for S. aureus. The isolated strains of S. aureus were screened for methicillin susceptibility by modified Kirby–Bauer method using cefoxitin (30 μg) disc. Further, antibiotic susceptibility testing for all isolates of S. aureus was also done against selected appropriate antibiotics. Vancomycin susceptibility testing for MRSA was done by E test.Results: The number of strains of S. aureus isolated from our 150 participants was 71 with a percentage rate of 47.3. Of the 71 isolates of S. aureus, one (1.4%) was MRSA. The overall MRSA carriage rate was 0.66%. The S. aureus and MRSA carriage rates recorded in this study were at par and significantly lower, respectively, when compared with other reported studies. It was observed that risk factors such as the use of antibiotics in the past 6 months and smoking were found to be statistically significant in nasal carriage status of S. aureus (<0.05). The only one isolate of MRSA was found to be sensitive to vancomycin, linezolid, and teicoplanin.Conclusion: It was concluded that the acquisition of S. aureus and MRSA would not be an occupational hazard for medical students of developing countries like India.

scholarly journals Impact of mass administration of azithromycin as a preventive treatment on the prevalence and resistance of nasopharyngeal carriage of Staphylococcus aureus

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257190
Author(s):  
Soumeya Hema-Ouangraoua ◽  
Juliette Tranchot-Diallo ◽  
Issaka Zongo ◽  
Nongodo Firmin Kabore ◽  
Frédéric Nikièma ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Infections ◽  
Methicillin Resistance ◽  
Pediatric Population ◽  
Preventive Treatment ◽  
Nasal Carriage ◽  
Post Intervention ◽  
Serious Illness ◽  
Increased Risk ◽  
The Impact

Staphylococcus aureus is a major cause of serious illness and death in children, indicating the need to monitor prevalent strains, particularly in the vulnerable pediatric population. Nasal carriage of S. aureus is important as carriers have an increased risk of serious illness due to systemic invasion by this pathogen and can transmit the infection. Recent studies have demonstrated the effectiveness of azithromycin in reducing the prevalence of nasopharyngeal carrying of pneumococci, which are often implicated in respiratory infections in children. However, very few studies of the impact of azithromycin on staphylococci have been undertaken. During a clinical trial under taken in 2016, nasal swabs were collected from 778 children aged 3 to 59 months including 385 children who were swabbed before administration of azithromycin or placebo and 393 after administration of azithromycin or placebo. Azithromycin was given in a dose of 100 mg for three days, together with the antimalarials sulfadoxine-pyrimethamine and amodiaquine, on four occasions at monthly intervals during the malaria transmission season. These samples were cultured for S. aureus as well as for the pneumococcus. The S. aureus isolates were tested for their susceptibility to azithromycin (15 g), penicillin (10 IU), and cefoxitine (30 g) (Oxoid Ltd). S. aureus was isolated from 13.77% (53/385) swabs before administration of azithromycin and from 20.10% (79/393) six months after administration (PR = 1.46 [1.06; 2.01], p = 0.020). Azithromycin resistance found in isolates of S. aureus did not differ significantly before and after intervention (26.42% [14/53] vs 16.46% [13/79], (PR = 0.62 [0.32; 1.23], p = 0.172). Penicillin resistance was very pronounced, 88.68% and 96.20% in pre-intervention and in post-intervention isolates respectively, but very little Methicillin Resistance (MRSA) was detected (2 cases before and 2 cases after intervention). Monitoring antibiotic resistance in S. aureus and other bacteria is especially important in Burkina Faso due to unregulated consumption of antibiotics putting children and others at risk.

scholarly journals Detection of Oxacillin (Methicillin)-resistant Staphylococcus aureus Isolated from a Tertiary-care Hospital, Georgetown, Guyana

2020 ◽  
pp. 1-7
Author(s):  
Paul Cheddie ◽  
Drovashti Seepersaud ◽  
Tereasia Ramlochan
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Prevalence Survey ◽  
Methicillin Resistant ◽  
Broth Microdilution Method

Background and Aim: Methicillin-resistant Staphylocccus aureus (MRSA) continues to be a major problem globally. Previous data had suggested that the prevalence of MRSA infections in the tertiary hospital setting was 51%. The aim of this study was to conduct a point prevalence survey of MRSA infections occurring at a tertiary-care hospital in Georgetown, Guyana, and to determine to what extent methicillin-resistance was occurring among Staphylococcus aureus isolates utilising the minimum inhibitory concentration (MIC) data. Study Design: This study was based on a prospective, analytical design. Place and Duration of Study: Microbiology department, Georgetown Public Hospital Corporation (GPHC), and Department of Medical Technology, University of Guyana, between May 2019 and July 2019. Methodology: A total of 101 consecutive, non-repetitive, laboratory-identified MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) isolates were tested using an oxacillin broth microdilution method. Results: We found that 65.4% of Staphylococcus aureus were oxacillin (methicillin) resistant with a majority of the isolates being high level oxacillin resistant strains (i.e., MICs > 256 μg/ml) (84.85%). Most of the resistant isolates were collected from patients admitted to medical and surgical wards. Conclusion: Methicillin-resistance continues to be a major problem in the hospital setting and conventional techniques are unlikely to identify all of the potentially resistant isolates.

scholarly journals Prevalence of Methicillin-resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Hospital in Northern India

2010 ◽  
Vol 2 (02) ◽  
pp. 078-081 ◽  
Author(s):  
Shilpa Arora ◽  
Pushpa Devi ◽  
Usha Arora ◽  
Bimla Devi
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Diffusion Method ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Sensitivity Pattern

ABSTRACT Aim: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) has posed a serious therapeutic challenge. We report the prevalence and antibiotic susceptibility pattern of MRSA in the hospitals attached to GMC, Amritsar, Punjab. Materials and Methods: The study comprised of 250 coagulase-positive staphylococci (COPS) isolated from a total of 6743 clinical specimens (like pus, blood, urine, high vaginal swab, sputum, etc.) of patients admitted in hospitals attached to Government Medical College, Amritsar from January 2008−February 2009. Routine antibiotic susceptibility testing was performed and interpreted as per standard guidelines. Methicillin resistance was detected using oxacillin and cefoxitin disc diffusion method, oxacillin screen agar method, and minimum inhibitory concentration using broth macrodilution method. Results: A total of 115 (46%) strains were found to be methicillin resistant. Multidrug resistance was observed in 73% MRSA strains. However, no strain was resistant to vancomycin. Conclusion: Regular surveillance of hospital-associated infection and monitoring of antibiotic sensitivity pattern is required to reduce MRSA prevalence.

scholarly journals Low Yield of Methicillin-Resistant Staphylococcus aureus Screening in Hemodialysis Patients: 10 Years’ Experience

2015 ◽  
Vol 36 (9) ◽  
pp. 1046-1049
Author(s):  
H. M. Gebreselassie ◽  
T. Kaspar ◽  
S. Droz ◽  
J. Marschall
Keyword(s):  
Staphylococcus Aureus ◽  
Cost Effectiveness ◽  
Mass Screening ◽  
Hemodialysis Patients ◽  
Alternative Strategy ◽  
High Risk Population ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Total Cost ◽  
Screening Approach

OBJECTIVETo determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization in hemodialysis patients and to analyze the cost-effectiveness of our screening approach compared with an alternative strategy.DESIGNScreening study and cost-effectiveness analysis.METHODSAnalysis of twice-yearly MRSA prevalence studies conducted in the hemodialysis unit of a 950-bed tertiary care hospital from January 1, 2004, through December 31, 2013. For this purpose, nasal swab samples were cultured on MRSA screening agar (mannitol-oxacillin biplate).RESULTSThere were 20 mass screenings during the 10-year study period. We identified 415 patients participating in at least 1 screening, with an average of 4.5 screenings per patient. Of 415 screened patients, 15 (3.6%) were found to be MRSA carriers. The first mass screening in 2004 yielded the highest percentage of MRSA (6/101 [6%]). Only 7 subsequent screenings revealed new MRSA carriers, whereas 4 screenings confirmed previously known carriers, and 8 remained negative. None of the carriers developed MRSA bacteremia during the study period. The total cost of our screening approach, that is, screening and isolation costs, was US $93,930. The total cost of an alternative strategy (ie, no mass screening administered) would be equivalent to costs of isolation of index cases and contact tracing was estimated to be US $5,382 (difference, US $88,548).CONCLUSIONSIn an area of low MRSA endemicity (<5%), regular nasal screenings of a high-risk population yielded a low rate of MRSA carriers. Twice-yearly MRSA screening of dialysis patients is unlikely to be cost-effective if MRSA prevalence is low.Infect. Control Hosp. Epidemiol. 2015;36(9):1046–1049

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