Abstract
BackgroundNasal carriage of Staphylococcus aureus among hospital personnel is a common cause of hospital acquired infections. Emergence of drug resistant strains especially methicillin resistant S. aureus (MRSA) is a serious problem in hospital environment. Therefore, the aim of this study was to determine the nasal carriage rate of S. aureus and MRSA among Health Care Workers (HCWs) at Al Shifa Hospital, the major hospital in Gaza Strip.MethodsA cross sectional study was conducted on 200 HCWs. Nasal swabs were collected during February — April 2015, and cultured on blood and mannitol salt agar. The isolates were identified as S. aureus based on morphology, coagulase test, DNase test and mannitol salt agar fermentation. Disk diffusion antibiotic susceptibility tests were performed according to the guidelines of the Clinical and Laboratory Standards Institute. MRSA were confirmed by detection of the mecA gene by PCR.ResultsOut of the 200 healthcare workers, 62 (31%) carried S. aureus, of which 51 (82.3%) were MRSA. Therefore, 25.5% of all HCWs were identified as MRSA carriers. MRSA carriage rate was highest among nurses (30.4%) whereas the carriage rate among doctors was (16%). The majority of MRSA carriers were workers of internal medicine department and surgical wards (41.3 and 35% respectively). Out of the 51 MRSA isolates identified by oxacillin disc resistance, 40 were confirmed by PCR targeting the mecA gene. Penicillin showed the highest rate of resistance among MRSA and MSSA isolates (100%).ConclusionsThe high rate of nasal MRSA carriage among healthcare workers found in this study is alarming and highlights the need for adjusted infection control measures to prevent MRSA transmission from HCWs to the vulnerable patient.
Highlights
Nasal carriage of Staphylococcus aureus among hospital personnel is a common cause of hospital acquired infections
Al Laham et al recently reported methicillin resistant S. aureus (MRSA) carriage rate of 22.6% among Health Care Workers (HCWs) in three different hospitals in Gaza Strip [13]. In this follow up study we report the prevalence of S. aureus and MRSA carriage in a larger group of HCWs from Al Shifa hospital with emphasis on its distribution based on different health care professions
Overall, 62 bacterial isolates were phenotypically identified as S. aureus as described in the materials and methods
Summary
Nasal carriage of Staphylococcus aureus among hospital personnel is a common cause of hospital acquired infections. The aim of this study was to determine the nasal carriage rate of S. aureus and MRSA among Health Care Workers (HCWs) at Al Shifa Hospital, the major hospital in Gaza Strip. MRSA is a major nosocomial pathogen that causes severe morbidity and mortality worldwide [1]. It has emerged as one of the commonest causes of hospital acquired infection and continues to remain an important factor contributing to failure of management [2]. HCWs who are at interface between the hospital and the Knowledge of the prevalence of MRSA and its antimicrobial profile is necessary for selection of the appropriate empirical antimicrobial treatment for S. aureus infections [5]. In 2007, a Mediterranean study found that the highest proportions of MRSA were reported by Egypt (52%), Cyprus (55%), Algeria (45%), Malta (50%) and Jordan (56%), in comparison to other Mediterranean countries such as Lebanon (12%), Tunisia (18%) and Morocco
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