Screening of Nasal Carriage of Mupirocin Resistant Staphylococcus aureus among Health Care Providers of Tertiary Care Hospital in Central India

Abstract

Introduction: Nasal carriage of Mupirocin resistant Staphylococcus aureus amongst Health Care Providers (HCP) is a matter of concern for Hospital acquired infection due to Methicillin resistant stains of S. aureus. CDC recommends use of Mupirocin for decolonization only in outbreaks or other high prevalence situations. This Cross-sectional Analytical study was carried out to assess the burden of Mupirocin resistance in nasal carriage isolates of Staphylococcus aureus in Health care providers form Tertiary care hospital in central India. Methods: Thirty non repetitive samples each from four groups of health care provider i.e. Consultants, Residents, Nursing staff & Cleaning Staff were collected after informed consent and ethical clearance. Samples from anterior nares were processed for isolation of S. aureus and screened for Methicillin resistance with MIC of Mupirocin. Data maintained in Microsoft office Excel was analyzed with statistical tools like tests of proportion & Chi Square test for significance. Results: Thirty five S. aureus strains were isolated of 120 samples collected of which 15 were MRSA. A total of 11 strains were found to be having High level Mupirocin resistant (MupH) of which 9 were Methicillin resistant while 2 were Methicillin sensitive. MupH strain colonization was more in Residents group but Low level Mupirocin Resistant was not found in any group. Statistically no difference was found between Clinical & Non Clinical Groups for MupH. Conclusion: MupH is on rise in MRSA as well as MSSA strains. Regular screening of HCP for nasal carriage of MRSA & use of Mupirocin only in outbreaks or critical areas in view of developing Mupirocin resistance is of prime importance. Key-words: Mupirocin resistance, Nasal colonization, MRSA, MIC, Health care provider, Hospital Acquired Infections Key Messages: The control and prevention of the infection ascribed to MRSA can only be achieved when there is a regular screening of carriers among healthcare provid