Methicillin-Resistant Staphylococcus aureus Nasal Colonization among Healthcare Workers at Kampala International University Teaching Hospital, Southwestern Uganda

Whereas Staphylococcus aureus is a pathogen, it colonizes healthy people as normal flora without causing any symptoms or illness. Probably because of greater exposure, healthcare workers (HCWs) are more colonized, serving as reservoir for endogenous infections as well as dissemination. In developing countries including Uganda, there is scarcity of the literature on S. aureus carriage among HCWs, making infection control difficult. This study aimed at determining the nasal carriage rate and comparing the antimicrobial susceptibility profiles of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus (MSSA) isolates from HCWs of Kampala International University Teaching Hospital. Nasal swab specimens from HCWs were screened for MRSA using both phenotypic and genotypic methods. Antimicrobial susceptibility testing of the MRSA and MSSA isolates was performed using the Kirby–Bauer disc diffusion method. Out of the 97 participants, 28 (28.8%) participants were nasal carriers of S. aureus of which 13 (46.4%) were phenotypically MRSA (resistant to cefoxitin) and 8 (28.6%) were genotypically MRSA (had mecA gene). Only 6 isolates of the 13 isolates (46%) which showed resistance to cefoxitin had mecA gene detectable while 2 (13.3%) of the 15 cefoxitin susceptible isolates were found to carry mecA gene. The study thus shows that methicillin resistance in S. aureus may not only be determined by mecA gene.

Antibiotic resistant airborne bacteria and their multidrug resistance pattern at University teaching referral Hospital in South Ethiopia

BACKGROUND

Hospitals provide a reservoir of microorganisms, many of which are multi-resistant to antibiotics. Emergence of multi-drug resistant strains in a hospital environment, particularly in developing countries is an increasing problem to infection treatment. This study aims at assessing antibiotic resistant airborne bacterial isolates.

METHODS

A cross-sectional study was conducted at Wolaita Sodo university teaching and referral Hospital. Indoor air samples were collected by using passive air sampling method. Sample processing and antimicrobial susceptibility testing were done following standard bacteriological techniques. The data was analyzed using SPSS version 20.

RESULTS

Medically important bacterial pathogens, Coagulase negative staphylococci (29.6%), Staphylococcus aureus (26.3%), Enterococci species, Enterococcus faecalis and Enterococcus faecium (16.5%), Acinetobacter species (9.5%), Escherichia coli (5.8%) and Pseudomonas aeruginosa (5.3%) were isolated. Antibiotic resistance rate ranging from 7.5 to 87.5% was detected for all isolates. Acinetobacter species showed a high rate of resistance for trimethoprim-sulfamethoxazole, gentamicin (78.2%) and ciprofloxacin (82.6%), 28 (38.9%) of S. aureus isolates were meticillin resistant, and 7.5% Enterococci isolates of were vancomycin resistant. 75.3% of all bacterial pathogen were multi-drug resistant. Among them, 74.6% were gram positive and 84% were gram negative. Multi-drug resistance were observed among 84.6% of P. aeruginosa, of 82.5% Enterococcii, E. coli 78.6%, S. aureus 76.6%, and Coagulase negative staphylococci of 73.6%.

CONCLUSIONS

Indoor environment of the hospital was contaminated with airborne microbiotas, which are common cause of post-surgical site infection in the study area. Bacterial isolates were highly resistant to commonly used antibiotics with high multi-drug resistance percentage. So air quality of hospital environment, in restricted settings deserves attention, and requires long-term surveillance to protect both patients and healthcare workers.

Antimicrobial susceptibility pattern of nasal Staphylococcus aureus among Dessie Referral Hospital health care workers, Dessie, Northeast Ethiopia

BACKGROUND

Staphylococcus aureus is a major pathogen in skin and soft tissue infections. Methicillin-resistant S. aureus (MRSA) is prevalent in most of the countries in which it is sought. MRSA is one of the important pathogens implicated in hospital-acquired infections. The main objectives of this study were to determine the antimicrobial susceptibility pattern of S. aureus isolates, the prevalence of MRSA, and the nasal carriage rate in healthy hospital staff members.

METHODS

A total of 118 health care workers (HCWs) were enrolled using a cross-sectional study design. Nasal swabs were collected and cultured on mannitol salt agar (MSA). The slide coagulase test was performed. Susceptibility testing was carried out on Mueller-Hinton agar using the modified Kirby-Bauer disk diffusion method with 10 antibiotics.

RESULTS

Of the 118 HCWs, 34 had S. aureus and 15 had MRSA, with overall positivity rates of 28.8% and 12.7%, respectively. None of the S. aureus isolates were sensitive to penicillin. MRSA isolates were resistant to commonly available antibiotics. Only two (13.3%) of the nasal isolates were vancomycin-resistant.

CONCLUSIONS

A high rate of nasal carriage and multidrug-resistant S. aureus was found in this study, indicating the need for standard infection control to prevent transmission in our health care setting.