scholarly journals Methicillin Resistant Staphylococcus aureus nasal carriage and associated factors in a rural tertiary hospital in Eastern Uganda: A prospective cross-sectional study

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):  
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.


2007 ◽  
Vol 13 (4) ◽  
pp. 289-295 ◽  
Author(s):  
Marilyn Felkner ◽  
Rodney E. Rohde ◽  
Ana Maria Valle-Rivera ◽  
Tamara Baldwin ◽  
L. P. (Sky) Newsome

2022 ◽  
Author(s):  
Ermiyas Mekuriya ◽  
Aseer Manilal ◽  
Addis Aklilu ◽  
Melat Woldemariam ◽  
Tadios Hailu ◽  
...  

Abstract Individuals with Methicillin-Resistant Staphylococcus aureus (MRSA) colonized nasal cavities were at greater risk of developing the infection and can serve as potential reservoirs of transmission. Aim of this study is to determine the extent of nasal carriage and associated factors linked to MRSA in medical and health science students of Arba Minch University (AMU), Ethiopia. An institution based cross-sectional study was conducted at AMU from 01st August through 30th November, 2020. A systematic sampling technique was used to recruit the participants. Socio-demographic data were collected using a structured questionnaire. Nasal swabs were collected and S. aureus were identified following standard microbiological methods. Methicillin resistance was tested using cefoxitin disk and antimicrobial susceptibility tests were performed by Kirby-Bauer disk diffusion. Biofilm forming ability was phenotypically detected by micro-titer plate assay. Descriptive statistics and multivariable logistic regression analysis were done by Statistical Package for Social Service (SPSS) version 25. Overall prevalence of Staphylococcus aureus and MRSA were 27.1% (70/258) and 7.4% (19/258) respectively. Methicillin-Resistant S. aureus carriage was higher among medical interns, 16.9% (11/65); isolates were co-resistant to antibiotics, such as trimethoprim-sulfamethoxazole (63.2%) and tetracycline (48.4%). Multidrug resistance (MDR) was observed among 52.6% (10/19) of the isolates. Besides, 31.4% (6/19) of MRSA were biofilm producers and all of them were MDR. Multivariable analysis showed that students having >2 years of mean exposure to hospital [p= 0.048, AOR: 4.99, 95% CI: 1.01-24.66] and those who share clothing and sports equipment [p=0.017, AOR: 5.43, 95% CI: 1.35-21.83] were statistically significant. The overall prevalence of nasal MRSA among students were comparatively lower than that observed in other studies done in Ethiopia itself. An alarming factor is that, 60% of MDR-MRSA were biofilm producers.


2013 ◽  
Vol 141 (5-6) ◽  
pp. 349-353 ◽  
Author(s):  
Ivana Cirkovic ◽  
Slobodanka Djukic ◽  
Dragana Vukovic ◽  
Goran Stevanovic ◽  
Milena Svabic-Vlahovic ◽  
...  

Introduction Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) present the growing problem in the whole world. Carriage of MRSA is most frequent in the nose, and medical students come in contact both with patients and different persons in the community. Therefore, they may be significant for the transmission of MRSA from hospitals to out- of-hospital communities and vice versa. Objective. The aim of this study was to establish the carriage rate among students of the second, third and fourth year of study at the School of Medicine in Belgrade and to analyze their genotypic and phenotypic characteristics. Methods. In total 533 nasal samples were taken. The samples were incubated in Trypcase-soy broth supplemented with 6.5% NaCl, and thereafter the swabs were inoculated on mannitol salt agar supplemented with 2 ?g/mL of oxacillin. The presence of nuc, mecA and Panton-Valentine leukocidin genes was examined by PCR. The characteristics of the MRSA strains were determined using: antibiotic susceptibility testing by Vitek2 System, SCCmec, agr typing and MLST. Results. MRSA was isolated from two of 533 investigated samples (0.37%). MRSA were isolated from the students of the second and third year of study. Profiles of strains were: ST80 (SCCmec type IV, agr type 3) and ST152 (SCCmec type V, agr type 1). MRSA strains were multiresistant. Conclusion. The nasal carriage rate of MRSA in population of medical students of the first year of study in Belgrade is low. Genotypic and phenotypic characteristics of MRSA strains indicate their community origin. MLST typing revealed that isolates belong to ST80 and ST152.


2021 ◽  
Author(s):  
John Bosco Kalule ◽  
Valeria Nakintu ◽  
Simon Peter Ssendawula

Abstract Background Methicillin Resistant Staphylococcus aureus (MRSA) nasal carriage in domestic pigs and vervet monkeys is a risk factor for subsequent severe infections in domestic pigs and for dissemination to the human population. This study assessed nasal carriage of MRSA in domestic pigs and sympatric vervet monkeys in a rural African village during an outbreak of a virus hemorrhagic fever suspected to be contracted from wild primates. This study was conducted during the 2012 Ebola outbreak to determine nasal carriage of MRSA in free-ranging domestic pigs and sympatric freely roaming vervet monkeys using conventional methods. Staphylococcus aureus (S. aureus) isolated from the anterior nares were tested for susceptibility to commonly used antibiotics and conventional PCR was used to confirm methicillin resistance. Results MRSA was significantly more in wild vervet monkeys compared to free ranging domestic pigs (p=0.003875). Overall, there was a high level of resistance to tetracycline [90% (63/70) in pigs and 67% (10/15) in vervet monkeys], trimethoprim/sulphamethoxazole [90% (63/70) in pigs and 67% (10/15) in vervet monkeys], and penicillin [83% (58/70) in pigs and 67% (10/15) in vervet monkeys]. Conclusion The nasal carriage of drug resistant S. aureus in freely roaming domestic and wild animals presents a risk for widespread environmental spread of antimicrobial resistance thus presenting a risk for treatment failure in domestic animals, wild animals, and humans.


Author(s):  
Isha Juneja ◽  
Ashwini Hegde ◽  
Pooja Rao ◽  
Radhakrishna M

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 prime objective of the study was to ascertain the prevalence of carriage rate of MRSA among the clinical postgraduate students of a medical college of Coastal Karnataka, India.Methods: A total of 133 clinical postgraduates have participated in the present study. Swabs from both anterior nares were collected and processed for S. aureus from the consenting participants after giving a set of questionnaires. The isolated strains of S. aureus were screened for methicillin resistance by the modified Kirby-Bauer method using cefoxitin (30 μg) disc. Antibiotic susceptibility testing for all isolates of S. aureus was also done against other antibiotics. E test was used to know vancomycin resistance for MRSA.Results: The numbers of S. aureus isolated of 133 participants were 22 (16.5%). Of 22 isolates of S. aureus, 12 were MRSA (54.5%). The MRSA carriage rate of clinical postgraduates of a medical college from Coastal Karnataka, India, was 9%. All the MRSA isolates were susceptible to vancomycin and teicoplanin. Contact with chronic patients and consumption of antibiotics in past 6 months were found to be statistically significant as the risk factor associated with the acquisition of S. aureus/MRSA carriage status among the participants. No vancomycin-resistant S. aureus was reported from the present study.Conclusion: The S. aureus and MRSA nasal carriage rates of clinical postgraduates recorded in this study were significantly high when compared with the general population. This could be due to their continuous exposure to patients in clinical settings. It is desirable that these students must receive sufficient knowledge regarding control measures to avoid the spread of MRSA infection in hospitals.


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