Copyright (c) 2020 Dr.Vedavati B. I
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
In Vitro Activity of Mupirocin on Staphylococcal Nasal Carriers Among Health Care Providers of Post Operative Surgical Ward in a Tertiary Care Hospital
Corresponding Author(s) : Dr.Vedavati B. I
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 2 No. 4 (2014): 2014 Volume 2- Issue -4
Abstract
BACKGROUND
Methicillin-resistant Staphylococcus aureus (MRSA) has been associated with considerable morbidity and mortality and is a important public health issue. It is an opportunistic pathogen. The increasing resistance of this pathogen to various antibiotics complicates treatment of S.aureus infections. Effective measures to prevent S aureus infections are therefore urgently needed.
AIM
To evaluate the trend of mupirocin resistance in nasal colonization of Staphylococcus in patients’ attendants and health care workers of post operative surgical ward of a tertiary care hospital.
METHODS
Total of 66 health care providers was studied. Nasal swabs were collected and processed for bacterial culture and antibiotic sensitivity. Methicillin resistance was detected by disc diffusion method using cefoxitin (30mcg) disc & mupirocin sensitivity using mupirocin (5mcg) disc.
RESULTS
39(67.24%) of patients attendants has Staphylococcus carriage of which 94.87% were s. aureus. 9(24.33%) of S.aureus were MRSA. All health care worker had S.aureus colonization of which 6 (75.00%) were MRSA. Overall 2(4.45%) S. aureus isolates from health care providers were resistant to muporocin.
CONCLUSION
Regular surveillance to know carrier prevalence and effective infection control initiatives are needed to reduce the incidence of health care associated infections due to MRSA. Monitoring of mupirocin resistance is essential to device carrier eradication protocols.
Keywords
MRSA
Nasal carriers
Mupirocin
Cefoxitin
References
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[1] Fomda BA, Thokar MA, Khan A, Bhat JA, Zahoor D, Bashir G, Majid A, Ray P. Nasal carriage of Methicillinresistant Staphylococcus aureus among healthy population of Kashmir, India. Indian J Med Microbiol 2014;32:39-43
[2] C. Glen Mayhal, Hospital epidemiology and infection control, lippincott,williams& wilkins, 4th ed;p 385-409
[3] Prakash Sah, Komal Raj Rijal,Bikash Shakya,Bishnu Raj Tiwari,Prakash Ghimire. nasal carriage rate of staphylococcus aureus in hospital personnel of national medical college and teaching hospital and their antibiotic susceptibility pattern: JHAS, 2013, Vol. 3, No. 1 P 21-23
[4] Suzanne F. Bradley. Eradication or Decolonization of Methicillin-Resistant Staphylococcus aureus Carriage: What Are We Doing and Why Are We Doing It?; Clinical Infectious Diseases 2007; 44:186–9
[5] [Larkin S, Murphy B. Preoperative Decolonization of Methicillin-resistant Staphylococcus aureus. ORTHOPEDICS.2008; 31:
[6] Ray P, Singh R. Methicillin-resistant Staphylococcus aureus carriage screening in intensive care. Indian J Crit Care Med 2013;17:205-6
[7] Mackie & McCartney, practical medical microbiology, j.gerald collee, andrew g. fraser. Barrie p. marmion, anthony simmons,14th ed; p 245-261
[8] CLSI. Performance standards for antimicrobial susceptibility testing; twenty-third informational supplement. CLSI document M100-S23. Wayne, PA: Clinical And Laboratory Standards Instituite 2013.
[9] Harbarth S,Dharan S,Liassine N,Pascale Herrault, Raymond Auckenthaler, Didier Pittet. Randomized, Placebo-Controlled, Double-Blind Trial To Evaluate the Efficacy of Mupirocin for Eradicating Carriage of Methicillin-Resistant Staphylococcus aureus. Antimicrob Agents Chemother. 1999 Jun;43(6):1412-6
[10] Sharon Rainy Rongpharpi, Naba Kumar Hazarika, Hitesh Kalita. Prevalence of Nasal Carriage of StaphylococcusAureus Among Healthcare Workersat a Tertiary Care Hospital in Assam with Special Reference to MRSA. J Clin Diagn Res. 2013 February; 7(2): 257–260.
[11] K Rajaduraipandi, KR Mani, K Panneerselvam, M Mani, M Bhaskar, P Manikandan. Prevalence and Antimicrobial Susceptibility Pattern of Methicillin Resistant Staphylococcus Aureus: A Multicentre Study. Indian Journal of Medical Microbiology, (2006) 24 (1):34-8
[12] Andrea Guyot, Graham Layer. MRSA – ‘Bug-Bear’ of a Surgical Practice: Reducing the Incidence of MRSA Surgical Site Infections. Ann R Coll Surg Engl. Mar 2006; 88(2): 222–223.
[13] Vijay H. Aswani, MD, PhD and Sanjay K. Shukla, PhD. Prevalence of Staphylococcus aureus and Lack of Its Lytic Bacteriophages in the Anterior Nares of Patients and Healthcare Workers at a Rural Clinic. Clin Med Res. Jun2011. 9(2) : 75-81
[14] Alireza Sharif1, Mohammad Reza Sharif2*, Javad Alizargar3 . Prevalence of Methicillin Resistance Staphylococcus aureus Colonization in Anterior Nares of Healthcare Workers in Alzahra Hospital. Journal of Medical Research Vol. 3(4). pp.046-048
[15] Lakshmi S. Kakhandki, B.V. Peerapur Study of nasal carriage of MRSA among the clinical staff and health care workers of a teaching hospital of Karnataka, India. Al Ameen J Med Sc i 2012; 5(4) : 367-370 _ US National Library of Medicine enlisted journal _ ISSN 0974-1143
[16] Malini J., Shruti A. Harle, Padmavathy M., Umapathy B.L., Navaneeth B.V., Keerthi Mannan J., et al.. Methicillin Resistant Staphylococcus Aureus Carriage Among The Health Care Workers In A Tertiary Care Hospital. Journal of Clinical and Diagnostic Research [serial online] 2012 June [cited: 2014 Jun 23 ]; 6:791-793.
[17] Josely Pinto de Moura, Fabiana Cristina Pimenta; Miyeko HayashidaI; Elaine Drehmer de Almeida Cruz; Silvia Rita Marin da Silva Canini; Elucir Gir. Colonization of nursing professionals by Staphylococcus Aureus. Rev. Latino-Am. Enfermagem vol.19 no.2 Ribeirão Preto Mar./Apr. 2011
[18] Jeffrey C. Jones, Theodore J. Rogers, Peter Brookmeyer, William Michael Dunne, Jr. et al. Mupirocin Resistance in Patients Colonized with Methicillin?Resistant Staphylococcus aureus in a Surgical Intensive Care Unit. Clinical Infectious Diseases 2007;45:541–547
[19] Saroj Golia, Vivek Hittinahalli, Asha S. Kamath B and Nirmala A. R. a study of nasal carriage of mrsa among the health care workers of a tertiary care hospital, bangalore. International Journal of Basic and Applied Medical Sciences 2013 Vol. 3 (1) January-March, pp.3-7
[20] Donker JMW, van der Laan L, Hendriks YJAM, Kluytmans JAJW (2012) Evaluation of Staphylococcus aureus Nasal Carriage Screening before Vascular Surgery. PLoS ONE 7(6): e38127.
[21] Goyal R, Das S, Mathur M. Colonisation of methicillin resistant Staphylococcus aureus among health care workers in a tertiary care hospital of Delhi. Indian J Med Sci 2002;56:321-4
[22] Nizamuddin, S., Irfan, S., Zafar, A. (2011). Evaluation of prevalence of low and high level mupirocin resistance in methicillin resistant Staphylococcus aureus isolates at a tertiary care hospital. Journal of the Pakistan Medical Association, 61(6), 519-21.
References
[1] Fomda BA, Thokar MA, Khan A, Bhat JA, Zahoor D, Bashir G, Majid A, Ray P. Nasal carriage of Methicillinresistant Staphylococcus aureus among healthy population of Kashmir, India. Indian J Med Microbiol 2014;32:39-43
[2] C. Glen Mayhal, Hospital epidemiology and infection control, lippincott,williams& wilkins, 4th ed;p 385-409
[3] Prakash Sah, Komal Raj Rijal,Bikash Shakya,Bishnu Raj Tiwari,Prakash Ghimire. nasal carriage rate of staphylococcus aureus in hospital personnel of national medical college and teaching hospital and their antibiotic susceptibility pattern: JHAS, 2013, Vol. 3, No. 1 P 21-23
[4] Suzanne F. Bradley. Eradication or Decolonization of Methicillin-Resistant Staphylococcus aureus Carriage: What Are We Doing and Why Are We Doing It?; Clinical Infectious Diseases 2007; 44:186–9
[5] [Larkin S, Murphy B. Preoperative Decolonization of Methicillin-resistant Staphylococcus aureus. ORTHOPEDICS.2008; 31:
[6] Ray P, Singh R. Methicillin-resistant Staphylococcus aureus carriage screening in intensive care. Indian J Crit Care Med 2013;17:205-6
[7] Mackie & McCartney, practical medical microbiology, j.gerald collee, andrew g. fraser. Barrie p. marmion, anthony simmons,14th ed; p 245-261
[8] CLSI. Performance standards for antimicrobial susceptibility testing; twenty-third informational supplement. CLSI document M100-S23. Wayne, PA: Clinical And Laboratory Standards Instituite 2013.
[9] Harbarth S,Dharan S,Liassine N,Pascale Herrault, Raymond Auckenthaler, Didier Pittet. Randomized, Placebo-Controlled, Double-Blind Trial To Evaluate the Efficacy of Mupirocin for Eradicating Carriage of Methicillin-Resistant Staphylococcus aureus. Antimicrob Agents Chemother. 1999 Jun;43(6):1412-6
[10] Sharon Rainy Rongpharpi, Naba Kumar Hazarika, Hitesh Kalita. Prevalence of Nasal Carriage of StaphylococcusAureus Among Healthcare Workersat a Tertiary Care Hospital in Assam with Special Reference to MRSA. J Clin Diagn Res. 2013 February; 7(2): 257–260.
[11] K Rajaduraipandi, KR Mani, K Panneerselvam, M Mani, M Bhaskar, P Manikandan. Prevalence and Antimicrobial Susceptibility Pattern of Methicillin Resistant Staphylococcus Aureus: A Multicentre Study. Indian Journal of Medical Microbiology, (2006) 24 (1):34-8
[12] Andrea Guyot, Graham Layer. MRSA – ‘Bug-Bear’ of a Surgical Practice: Reducing the Incidence of MRSA Surgical Site Infections. Ann R Coll Surg Engl. Mar 2006; 88(2): 222–223.
[13] Vijay H. Aswani, MD, PhD and Sanjay K. Shukla, PhD. Prevalence of Staphylococcus aureus and Lack of Its Lytic Bacteriophages in the Anterior Nares of Patients and Healthcare Workers at a Rural Clinic. Clin Med Res. Jun2011. 9(2) : 75-81
[14] Alireza Sharif1, Mohammad Reza Sharif2*, Javad Alizargar3 . Prevalence of Methicillin Resistance Staphylococcus aureus Colonization in Anterior Nares of Healthcare Workers in Alzahra Hospital. Journal of Medical Research Vol. 3(4). pp.046-048
[15] Lakshmi S. Kakhandki, B.V. Peerapur Study of nasal carriage of MRSA among the clinical staff and health care workers of a teaching hospital of Karnataka, India. Al Ameen J Med Sc i 2012; 5(4) : 367-370 _ US National Library of Medicine enlisted journal _ ISSN 0974-1143
[16] Malini J., Shruti A. Harle, Padmavathy M., Umapathy B.L., Navaneeth B.V., Keerthi Mannan J., et al.. Methicillin Resistant Staphylococcus Aureus Carriage Among The Health Care Workers In A Tertiary Care Hospital. Journal of Clinical and Diagnostic Research [serial online] 2012 June [cited: 2014 Jun 23 ]; 6:791-793.
[17] Josely Pinto de Moura, Fabiana Cristina Pimenta; Miyeko HayashidaI; Elaine Drehmer de Almeida Cruz; Silvia Rita Marin da Silva Canini; Elucir Gir. Colonization of nursing professionals by Staphylococcus Aureus. Rev. Latino-Am. Enfermagem vol.19 no.2 Ribeirão Preto Mar./Apr. 2011
[18] Jeffrey C. Jones, Theodore J. Rogers, Peter Brookmeyer, William Michael Dunne, Jr. et al. Mupirocin Resistance in Patients Colonized with Methicillin?Resistant Staphylococcus aureus in a Surgical Intensive Care Unit. Clinical Infectious Diseases 2007;45:541–547
[19] Saroj Golia, Vivek Hittinahalli, Asha S. Kamath B and Nirmala A. R. a study of nasal carriage of mrsa among the health care workers of a tertiary care hospital, bangalore. International Journal of Basic and Applied Medical Sciences 2013 Vol. 3 (1) January-March, pp.3-7
[20] Donker JMW, van der Laan L, Hendriks YJAM, Kluytmans JAJW (2012) Evaluation of Staphylococcus aureus Nasal Carriage Screening before Vascular Surgery. PLoS ONE 7(6): e38127.
[21] Goyal R, Das S, Mathur M. Colonisation of methicillin resistant Staphylococcus aureus among health care workers in a tertiary care hospital of Delhi. Indian J Med Sci 2002;56:321-4
[22] Nizamuddin, S., Irfan, S., Zafar, A. (2011). Evaluation of prevalence of low and high level mupirocin resistance in methicillin resistant Staphylococcus aureus isolates at a tertiary care hospital. Journal of the Pakistan Medical Association, 61(6), 519-21.
[2] C. Glen Mayhal, Hospital epidemiology and infection control, lippincott,williams& wilkins, 4th ed;p 385-409
[3] Prakash Sah, Komal Raj Rijal,Bikash Shakya,Bishnu Raj Tiwari,Prakash Ghimire. nasal carriage rate of staphylococcus aureus in hospital personnel of national medical college and teaching hospital and their antibiotic susceptibility pattern: JHAS, 2013, Vol. 3, No. 1 P 21-23
[4] Suzanne F. Bradley. Eradication or Decolonization of Methicillin-Resistant Staphylococcus aureus Carriage: What Are We Doing and Why Are We Doing It?; Clinical Infectious Diseases 2007; 44:186–9
[5] [Larkin S, Murphy B. Preoperative Decolonization of Methicillin-resistant Staphylococcus aureus. ORTHOPEDICS.2008; 31:
[6] Ray P, Singh R. Methicillin-resistant Staphylococcus aureus carriage screening in intensive care. Indian J Crit Care Med 2013;17:205-6
[7] Mackie & McCartney, practical medical microbiology, j.gerald collee, andrew g. fraser. Barrie p. marmion, anthony simmons,14th ed; p 245-261
[8] CLSI. Performance standards for antimicrobial susceptibility testing; twenty-third informational supplement. CLSI document M100-S23. Wayne, PA: Clinical And Laboratory Standards Instituite 2013.
[9] Harbarth S,Dharan S,Liassine N,Pascale Herrault, Raymond Auckenthaler, Didier Pittet. Randomized, Placebo-Controlled, Double-Blind Trial To Evaluate the Efficacy of Mupirocin for Eradicating Carriage of Methicillin-Resistant Staphylococcus aureus. Antimicrob Agents Chemother. 1999 Jun;43(6):1412-6
[10] Sharon Rainy Rongpharpi, Naba Kumar Hazarika, Hitesh Kalita. Prevalence of Nasal Carriage of StaphylococcusAureus Among Healthcare Workersat a Tertiary Care Hospital in Assam with Special Reference to MRSA. J Clin Diagn Res. 2013 February; 7(2): 257–260.
[11] K Rajaduraipandi, KR Mani, K Panneerselvam, M Mani, M Bhaskar, P Manikandan. Prevalence and Antimicrobial Susceptibility Pattern of Methicillin Resistant Staphylococcus Aureus: A Multicentre Study. Indian Journal of Medical Microbiology, (2006) 24 (1):34-8
[12] Andrea Guyot, Graham Layer. MRSA – ‘Bug-Bear’ of a Surgical Practice: Reducing the Incidence of MRSA Surgical Site Infections. Ann R Coll Surg Engl. Mar 2006; 88(2): 222–223.
[13] Vijay H. Aswani, MD, PhD and Sanjay K. Shukla, PhD. Prevalence of Staphylococcus aureus and Lack of Its Lytic Bacteriophages in the Anterior Nares of Patients and Healthcare Workers at a Rural Clinic. Clin Med Res. Jun2011. 9(2) : 75-81
[14] Alireza Sharif1, Mohammad Reza Sharif2*, Javad Alizargar3 . Prevalence of Methicillin Resistance Staphylococcus aureus Colonization in Anterior Nares of Healthcare Workers in Alzahra Hospital. Journal of Medical Research Vol. 3(4). pp.046-048
[15] Lakshmi S. Kakhandki, B.V. Peerapur Study of nasal carriage of MRSA among the clinical staff and health care workers of a teaching hospital of Karnataka, India. Al Ameen J Med Sc i 2012; 5(4) : 367-370 _ US National Library of Medicine enlisted journal _ ISSN 0974-1143
[16] Malini J., Shruti A. Harle, Padmavathy M., Umapathy B.L., Navaneeth B.V., Keerthi Mannan J., et al.. Methicillin Resistant Staphylococcus Aureus Carriage Among The Health Care Workers In A Tertiary Care Hospital. Journal of Clinical and Diagnostic Research [serial online] 2012 June [cited: 2014 Jun 23 ]; 6:791-793.
[17] Josely Pinto de Moura, Fabiana Cristina Pimenta; Miyeko HayashidaI; Elaine Drehmer de Almeida Cruz; Silvia Rita Marin da Silva Canini; Elucir Gir. Colonization of nursing professionals by Staphylococcus Aureus. Rev. Latino-Am. Enfermagem vol.19 no.2 Ribeirão Preto Mar./Apr. 2011
[18] Jeffrey C. Jones, Theodore J. Rogers, Peter Brookmeyer, William Michael Dunne, Jr. et al. Mupirocin Resistance in Patients Colonized with Methicillin?Resistant Staphylococcus aureus in a Surgical Intensive Care Unit. Clinical Infectious Diseases 2007;45:541–547
[19] Saroj Golia, Vivek Hittinahalli, Asha S. Kamath B and Nirmala A. R. a study of nasal carriage of mrsa among the health care workers of a tertiary care hospital, bangalore. International Journal of Basic and Applied Medical Sciences 2013 Vol. 3 (1) January-March, pp.3-7
[20] Donker JMW, van der Laan L, Hendriks YJAM, Kluytmans JAJW (2012) Evaluation of Staphylococcus aureus Nasal Carriage Screening before Vascular Surgery. PLoS ONE 7(6): e38127.
[21] Goyal R, Das S, Mathur M. Colonisation of methicillin resistant Staphylococcus aureus among health care workers in a tertiary care hospital of Delhi. Indian J Med Sci 2002;56:321-4
[22] Nizamuddin, S., Irfan, S., Zafar, A. (2011). Evaluation of prevalence of low and high level mupirocin resistance in methicillin resistant Staphylococcus aureus isolates at a tertiary care hospital. Journal of the Pakistan Medical Association, 61(6), 519-21.