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International Journal of Current Research in Medical Sciences - Distribution and Antibiotics Susceptibility Pattern of Staphylococcus aureus Isolates from Health Care Workers in Owerri, Nigeria
Abstract
The importance of Staphylococcus aureus as a persistent nosocomial and community-acquired pathogen has become of global health concern. It has a remarkable capacity of evolving different mechanisms of resistant to most antimicrobial agents. This study was aimed at determining the carrier rate of S. aureus among apparently healthy hospital staff members in five major hospitals in Owerri, Imo State Nigeria. A total of 156 nasal swab specimens collected from the health care workers (HCW) (78 males and 78 females) were cultured on manitol salt agar. S. aureus was identified by using standard microbiological techniques. Antibiotics susceptibility testing was carried out by Kirby-Bauer dick diffusion method. The overall carrier rate of S. aureus among the HCW was 47.4%. The antibiotic susceptibility test result shows that erythromycin was most active drug while highest resistance was observed in oxacilin. Statistical analysis showed that average number of resistance phenotypes per isolate was not significantly different in any of the sampled hospitals (P<0.05). The high carrier rate of S. aureus and antibiotics resistant observed in this study emphasizes the need for continues surveillance of the antibiotic susceptibility of S. aureus aimed at recommending appropriate and effective therapy in the treatment of staphylococcal infections
... Staphylococcal infections give rise to a wide spectrum of symptoms and diseases in humans. The bacterium is well characterized and known to have a diverse arsenal of virulence factors that causes a prominent inflammatory response [2,3]. This pathogen affects both immune competent and immuno compromised individuals, frequently resulting in high morbidity and with complications, which constitute problem to health care institutions [4]. ...
The global problem of increasing trend in antimicrobial resistance is particularly pressing in the developing countries, where antibiotic resistant bacteria is often the severe etiologic agent in hospital-acquired infections. This study was aimed to evaluate the frequency and antibiotic susceptibility pattern of Staphylococcus aureus isolated from various clinical specimens of outpatients attending Abia State University Teaching Hospital Aba, Nigeria. A total of 424 various clinical specimens comprising urine, pus, high vaginal swab, wound swab, throat swab, blood and stool were collected and cultured on Mannitol salt and MacConkey agar. S. aureus was identified based on their conventional cultural characteristics, Gram staining reaction and standard biochemical tests. All the isolates were tested for antimicrobial susceptibility by the disk diffusion technique according to the Clinical and Laboratory Standards Institute guidelines on Muller Hinton Agar. In all, 104 Staphylococcus aureus strains were isolated from the 424 clinical specimens (24.5% prevalence rate) with 40 (38.5%) of the isolates being methicillin resistant S. aureus (MRSA) and 64(61.5%) being methicillin susceptible S. aureus (MSSA) respectively. The highest prevalence was recorded in wound swab 10 (29.4%) while the least was observed in blood specimen 1(6.7%). Generally, the isolates showed high resistance to ampicillin (76.9%), penicillin G (81.7%), Nalidixic acid (72.1%), chloramphenicol (70.1%) and were considerably sensitive to gentamycin (68.3%), ciprofloxacin (61.5%) and cefpodoxime (66.3%). Statistical analysis showed that there was no significant difference on rate of resistance across the various clinical specimens (P< 0.05). This study highlighted high prevalence and antibiotic resistance; thus, the need to adopt new strategies in the control of antibiotic resistance cannot be overemphasized.
Background: In the hospitals where hygienic conditions are not provided, nasal methicillin resistant/sensitive Staphylococcus aureus (MRSA/MSSA) colonization is seen in the hospital personnel and patients. Both the individuals' themselves being MRSA/MSSA carriers and also other people around them are under risk and this bacterium leads to nasal colonization and then can propagate through contaminated hands and hospital materials. Objective: In this study, it was aimed to research MRSA/MSSA and beta-haemolytic streptococcus (BHS) carriage in the nose and throat flora of students of, School of Health. Methods: In the study, total of 160 midwifery students taking midwifery education was included in the research but 135 (84.4 %) out of 160 students were able to be reached. The nose and throat swab samples taken from students were examined through microbiological methods. Results: 14.1 % of students were nasal MSSA carrier. While there wasn't the nasal MRSA carrier among students attending the study in the 1st and 2nd class, 3.3 % (1 person) of the 3rd class students and 10.0 % (3 people) of the 4th class students were the nasal MRSA carrier. In addition, BHS carriage was determined in 1.5 % of students and there wasn't any difference between classes. Conclusions: These results indicate that midwifery students might have been contaminated with MSSA/MRSA during clinical practice. That MSSA/MRSA being an important pathogen is seen in midwifery students taking education in the birth units threatens the mother-child health.
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.
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.
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.
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.
To study the epidemiology of Staphylococcus aureus skin and soft-tissue infections (SSTIs) in hospitalised children and adults in Gaborone, Botswana, and to describe the changes in antimicrobial susceptibilities of S. aureus isolates over time.
A retrospective cohort study evaluated SSTI isolates from January 2000 to December 2007 at Princess Marina Hospital (PMH), a large tertiary referral centre in Gaborone. Eligible subjects were those hospitalised at PMH during the study period who had a skin or soft-tissue culture yielding a bacterial or fungal pathogen. The primary outcome measure was a skin or soft-tissue culture yielding S. aureus. Secondary outcomes were the organism's antimicrobial susceptibilities.
S. aureus was detected in 857 (35.8%) of single-organism SSTI cultures, and 194 (22.6%) of these isolates were methicillin resistant (MRSA). The proportion of MRSA isolates increased over time (linear test of trend: p=0.03 from 2000 to 2003), and MRSA isolates were more likely than methicillin-susceptible isolates to be resistant to commonly used antimicrobials recommended by the national SSTI treatment guideline.
We report a high and increasing proportion of MRSA SSTIs in Gaborone. This high rate of MRSA resistance to currently recommended empiric antibiotics for SSTIs dictates the need for revising national guidelines and ongoing prospective surveillance of SSTIs in this setting.
Present study was conducted to assess the nasal carriage rate of methicilin resistant Staphylococcus aureus (MRSA) among patients, visitors/patient attendants and healthcare personnel at National Medical College Teaching Hospital, Birgunj, Nepal. A total of 112 nasal swabs (patients: 31, visitors/patient attendants: 61, and healthcare personnel: 20) were subjected to bacteriological investigation following standard protocol. S. aureus isolates were identified by mannitol fermentation and coagulase positivity. Antimicrobial susceptibility test was performed by Kirby-Bauer's disc diffusion method on Muller-Hinton agar medium. S. aureus was isolated in 14 (12.5%) of participants (M: 11.3%, F: 13.6%). Highest nasal colonization rate was found among healthcare personnel (25.0%) followed by the visitors/patient attendants (13.1%) and the patients (3.2%) (P>0.05). Highest positive rate was observed in the age group d"14 years (33.3%), followed by 15 to 50 years (13.2%) and >50 years (5.6%) (P>0.05). Out of 14 S. aureus isolates, 57.1% were methicillin resistant, prevalence rate of MRSA among total subjects being 7.1%. MRSA prevalence rate were 5.6% and 8.5% in total male and female participants, respectively (P>0.05). Highest MRSA prevalence rate was among health-care personnel (10.0%), followed by visitors/patient attendants (8.2%) and the patients (3.2%) (P>0.05). All MRSA isolates were resistant to Ampicillin, followed by Cephalexin (37.5%), Ciprofloxacin (37.5%), Tetracycline (37.5%), Gentamycin (25.0%), Erythromycin (0.0%) and Vancomycin (0.0%). High rate of nasal MRSA carriage rate found in this study indicates the need for standard infection control to prevent MRSA transmission.
Nasal carriage of Staphylococcus aureus plays a key role in the epidemiology and pathogenesis of infection, and is a major risk factor for the development of both community-acquired and nosocomial infections. The objective of this study was to investigate the carriage rate of S. aureus in hospital personnel and normal population groups, and to compare the resistance rates of the isolated strains to certain antibiotics. The nasal carriage rates of S.aureus were found to be 27.5% in 262 hospital personnel, and 24.0% in 75 normal healthy subjects (p > 0.05). While methicillin resistant S. aureus rate was 9.7% in hospital personnel, no methicillin resistant strain was detected in the control group (p < 0.05). According to the in-vitro sensitivity test results, resistance rates of meticillin sensitive S. aureus (MSSA) strains isolated from hospital personnel to fusidic acid, erythromycin and clindamycin were as 11%, 18% and 12%, respectively. There were no resistant strains to these antibiotics among MSSA, isolated from normal subjects. In conclusion, the colonization of the resistant strains rather than the frequency of S. aureus colonization is more important in the hospital personnel.
Antimicrobial resistance of Staphylococcus aureus especially methicillin-resistant S. aureus (MRSA) continues to be a problem for clinicians worldwide. However, few data on the antibiotic susceptibility patterns of S. aureus isolates in South Africa have been reported and the prevalence of MRSA in the KwaZulu-Natal (KZN) province is unknown. In addition, information on the characterization of S. aureus in this province is unavailable. This study investigated the susceptibility pattern of 227 S. aureus isolates from the KZN province, South Africa. In addition, characterization of methicillin-sensitive S. aureus (MSSA) and MRSA are reported in this survey.
The in-vitro activities of 20 antibiotics against 227 consecutive non-duplicate S. aureus isolates from clinical samples in KZN province, South Africa were determined by the disk-diffusion technique. Isolates resistant to oxacillin and mupirocin were confirmed by PCR detection of the mecA and mup genes respectively. PCR-RFLP of the coagulase gene was employed in the characterization of MSSA and MRSA.
All the isolates were susceptible to vancomycin, teicoplanin and fusidic acid, and 26.9% of isolates studied were confirmed as MRSA. More than 80% of MRSA were resistant to at least four classes of antibiotics and isolates grouped in antibiotype 8 appears to be widespread in the province. The MSSA were also susceptible to streptomycin, neomycin and minocycline, while less than 1% was resistant to chloramphenicol, ciprofloxacin, rifampicin and mupirocin. The inducible MLSB phenotype was detected in 10.8% of MSSA and 82% of MRSA respectively, and one MSSA and one MRSA exhibited high-level resistance to mupirocin. There was good correlation between antibiotyping and PCR-RFLP of the coagulase gene in the characterization of MRSA in antibiotypes 1, 5 and 12.
In view of the high resistance rates of MRSA to gentamicin, erythromycin, clindamycin, rifampicin and trimethoprim, treatment of MRSA infections in this province with these antibacterial agents would be unreliable. There is an emerging trend of mupirocin resistance among S. aureus isolates in the province. PCR-RFLP of the coagulase gene was able to distinguish MSSA from MRSA and offers an attractive option to be considered in the rapid epidemiological analysis of S. aureus in South Africa. Continuous surveillance on resistance patterns and characterization of S. aureus in understanding new and emerging trends in South Africa is of utmost importance.
Characterization of nosocomial methicillin-susceptible Staphylococcus aureus isolates from Cape Verde showed that (i) Panton-Valentine leukocidin genes were present in 35% of the isolates and (ii) half
of the collection had the same genetic background as methicillin-resistant pandemic clones. Introduction of the staphylococcal
chromosome cassette mec (SCCmec) into virulent and epidemic isolates could pose serious threats to public health.
Changes in the organization of health services in developing countries have led to district levels assuming more responsibility for the planning, delivery and quality of community health care. This fully up-dated new edition has been produced to help those working in the district laboratory, and those responsible for the organization and management of community laboratory services and the training of district laboratory personnel. Replacing the previous publication Medical Laboratory Manual for Tropical Countries, this book provides an up-to-date practical bench manual, taking a modern approach to the provision of a quality medical laboratory service. Reviews: Review of District Laboratory Practice in Developing Countries Part 1: 'Clear and easily understood information is provided on the clinical biochemistry of laboratory analytes and the biology of parasites … The book is probably the most comprehensive source of information available today to those who work in or need to know about laboratory services in developing countries. It can be recommended as a basic document for laboratory technicians, technologists, and medical doctors at all levels …' Bulletin of the World Health Organization.
Healthcare workers (HCWs) are a major reservoir of meticillin-resistant Staphylococcus aureus (MRSA). A cross-sectional study was conducted between July and December 2010 to determine the prevalence of nasal carriage of MRSA at the Aga Khan University Hospital Nairobi. Nasal swabs were taken from 246 randomly selected HCWs. MRSA was identified using both phenotypic and genotypic methods. The prevalence of MRSA carriage was 0% [95% confidence interval (CI): 0-1.5%] whereas that of meticillin-susceptible Staphylococcus aureus was 18.3% (95% CI: 14.0-23.6%). Given the absence of MRSA in our hospital, screening HCWs should be limited to an outbreak setting.
We have studied prospectively the nasal carriage status of Staphylococcus aureus among all health-care workers in the Valdivia Hospital Base. A total of 522 nasal samples were evaluated. Nasal carriage rate was 34.9% for all personnel. Higher rates were seen in Pediatric wards and Central Kitchen Service. Isolated strains were resistant to penicillin (98.3%). However, sensitivity to other antimicrobial agents was high. According to the antimicrobial susceptibility pattern, we identified 12 different groups of strains or antibiotypes. Three of the multiple resistant antibiotypes (resistant to 4 or 5 antimicrobial agents) were isolated from pediatric wards.