Staphylococcus aureus: Nasal-carriage in Health Care Workers and In-patients with Special Reference to MRSA

Abstract

Aims: To find out the nasal carriage of Staphylococcus aureus in health care workers and in-patients in a tertiary care center. Study Design: Cross sectional study. year study 2013 Methodology: Nasal swabs were taken from health care workers (HCWs) and in-patients and these were processed for the recovery of Staphylococcus aureus ( S. aureus ) and methicillin resistant Staphylococcus aureus (MRSA). Antimicrobial susceptibility of the isolates to various antibiotics was performed as per Clinical Laboratory Standards Institute (CLSI), guidelines and D-test done to ascertain constitutive macrolide-lincosamide-streptogramin B (cMLS B ) and inducible macrolide-lincosamide-streptogramin B ( i MLS B ) phenotype. Risk factors for their carriage were also analyzed. Statistical analysis was done using SPSS software version 16 and a P value of < 0.05 was taken as significant. Results: Higher rate of isolation of S. aureus and MRSA was seen among 480 in-patients (47.1% and 32.7% respectively) compared with 256 HCWs (32.8% and 19.1% respectively). Significant resistance (P<0.05) to clindamycin, erythromycin, ciprofloxacin, tetracycline and co-trimoxazole was seen in MRSA isolates recovered from in-patients. MRSA isolates had higher cMLS B and i MLS B resistance. Years of service and level of education in HCWs were significantly associated with MRSA carriage in them. Conclusion: Nasal-carriage of S. aureus and MRSA is common in HCWs and in-patients in our hospital. Apart from periodic screening for MRSA carriage, strict adherence to existing infection control guidelines is mandatory.