Nasal and Hand Carriage Rate of Methicilin Resistant Staphylococcus Aureus (MRSA)Among Health Care Workers in Mekelle Hospitals
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Date
2011-05
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Addis Ababa University
Abstract
Background: Methicillin resistant Staphylococcus aureus (MRSA) is the most significant pathogen responsible for hospital and community based infections that ranges from mild skin infection to serious and invasive disease such as pneumonia, septicemia. Nosocomial infections due to MRSA are a known cause of increased hospital stay, cost, morbidity and mortality especially among the critically ill patients. In most hospitals of developing countries like Ethiopia there is no surveillance system for nasal and hand MRSA carriage among HCWs. So, the aim of this study was to assess the carriage of MRSA in HCW.
Methods: A cross sectional study between Nov/2010-Jan/2011 was carried out to screen all the health care workers (HCW)in all wards of the Ayder Referral Hospital (ARH) and Mekelle Hospital (MH) for MRSA nasal and hand carriage rate. Swabs of both anterior nares and finger web of the hands were taken, transported to regional laboratory. The samples were inoculated onto Mannitol Salt agar (MSA)and incubated aerobically at 37 0C for 48 hrs. Saureus was identified as mannitol fermenter and coagulase test positive. Anti- microbial susceptibility test for MRSA was done by Kirby-Bauer’s disk diffusion method using oxacillin disk.
Results: Out of the 177 Health Care Workers screened, 36(20.3 %)of them were MRSA carriers in their hand and anterior nares. Females 25(14.1%)were highly colonized by MRSA than males 11(6.21 %) (P=0.044, Odds ratio=1.41). Nasal carriage of MRSA 25(14.1 %)was higher than hand carriage 11(6.2 %)(P<0.05). Nurses 26(13.6 %)and medical doctors 4(2.3 %)were the most predominant carriers for MRSA. The isolated MRSA were multidrug resistant to other commonly available antibiotics. They were resistant to Ampicillin (88.9 %), Tetracycline (86.1%), Amoxicillin (75%), Chloramphenicol (58.3 %)and Cftriaxone(52.8 %). Only two (5.6%) of the nasal isolates were Vancomycin resistant.
Conclusion: MRSA carriage among HCWs in this study was high. The carriage rate was higher among nurses and doctors. The MRSA isolates were multi drug resistant to other antibiotics which may lead to increased morbidity and mortality if transmitted to critically-ill patients. So, the result of this study shows more emphasizes for the need of regular surveillance of HCWs.
It also calls a need for an effective infection prevention and control program.
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Keywords
Methicillin, Resistance, Staphylococcus aureus, Mekelle, Health care workers