Methicillin-Resistant Staphylococcus Aureus : Prevalence And Risk Factors Among Healthcare Workers :
MRSA Among Healthcare Workers
DOI:
https://doi.org/10.70284/njirm.v4i4.2201Keywords:
Health care workers, Methicillin-resistant Staphylococcus aureus, Risk factors, Infection control strategyAbstract
Background & Objectives: Awareness of Methicillin-resistant Staphylococcus aureus (MRSA) is still lacking in various regions of developing countries. The present study was carried out to assess the prevalence and to establish significant risk factors for colonization with MRSA in health care workers. Methods: A cross sectional study was carried out. Ninety one health care workers and were screened for MRSA by nasal swabbing. MRSA strains were detected by disc diffusion and chromogenic agar. The D test was also carried out to detect inducible clindamycin resistance. Hand hygiene practices were surveyed. Results:Twenty MRSA carriers were identified among the 91 health care workers (21.98%; CI95:13.97-31.88 %). A high prevalence was found in emergency ward (62.5 %; CI95: 24.49 -91.48 %) (p <0.05) .The surgical and orthopedic departments also showed high prevalence (54.55% and 75% respectively) (p< 0.001). Inducible clindamycin resistance was found in 20.45% samples. Chromogenic agar was found to have high sensitivity and results were similar to those of disc diffusion (p<0.001). Interpretation & Conclusion: The presence of significant risk factors aids in identification of high risk groups among hospital staff. Selective surveillance and effective lab techniques implemented in these groups will reduce the burden of MRSA in hospitals
References
2. Albrich WC, Harbarth S. Health-care workers: source, vector, or victim of MRSA?.Lancet Infect Dis 2008;8: 289–301
3. Vonberg RP, Stamm-Balderjahn S, Hansen Set al. How often do asymptomatic healthcare workers cause methicillin-resistant Staphylococcus aureusoutbreaks? A systematic evaluation. Infect Control Hosp Epidemiol 2006; 27: 1123–27.
4. Eveillard M, Martin Y, Hidri N, Boussougant Y, Joly-Guillou ML.Carriage of methicillin-resistant Staphylococcus aureus among hospital employees: prevalence, duration, and transmission to households.Infect Control Hosp Epidemiol 2004; 25:114-120.
5. Haamann F, Dulon M, Nienhaus A.MRSA as an occupational disease: a case series. Int Arch Occup Environ Health2011;84:259-266.
6. 6. Clinical and Laboratory Standards Institute. Performance standards for antimicrobialsusceptibility testing; 16 thinformational supplement. CLSI M100-S16. Wayne, PA: Clinical and Laboratory Standards Institute; 2006.
7. McDougal LK, Thornsberry C. New recommendations for disk diffusion antimicrobial susceptibility tests for methicillin-resistant (heteroresistant) staphylococci.J Clin Microbiol 1984;19:482-8.
8. Steward CD, Raney PM, Morrell AK et al. Testing for induction of clindamycin resistance in erythromycin resistant isolates of Staphylococcus aureus. J Clin Microbiol 2005;43:1716-21.
9. Tsering DC, Pal R, Kar S.Methicillin-resistant Staphylococcus Aureus. Prevalence and current susceptibility pattern in Sikkim.J Global Infect Dis 2011;3:9-13
10. Askarian M, Zeinalzadeh A, Japoni A, Alborzi A, Memish ZA. Prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus and its antibiotic susceptibility pattern in healthcare workers at Namazi Hospital, Shiraz, Iran. Int J Infect Dis. 2009 ;13(5):e241-7.
11. Weinerman, E. R. Ratner RS, Robbins A, Lavenhar MA. Yale studies in ambulatory medical care: V.Determinants of use of hospital emergency services.Am. J. Public Health 1966; 56: 1037-56
12. Flesh R, Brook R, Wassertheil-Smoller S, Jonas S. Monitoring utilization of municipal hospital emergency department. Hosp Topics 1976; 54 :43
13. Cesur S, Çokça F.Nasal Carriage of Methicillinâ€Resistant Staphylococcus aureus Among Hospital Staff and Outpatients.Infect Control Hosp Epidemiol 2004;25 : 169-171.
14. World Health Organization (WHO): WHO Guidelines on Hand Hygiene in Health Care (Advanced Draft): A Summary. Geneva, Switzerland: WHO, 2006.
15. O’Boyle CA, Henly SJ, Larson E. Understanding adherence to hand hygiene recommendations: the theory of planned behavior. Am J Infect Control 2001;29: 352-360.
16. Haas JP, Larson EL. Measurement of compliance with hand hygiene. J Hosp Infect2007; 66:6-14.
17. Joshi SC, Diwan V, Tamhankar AJ et al.Qualitative study on perceptions of hand hygiene among hospital staff in a rural teaching hospital in India. J Hosp Infect 2012;80(4): 340-4.
18. Alp E, Ozturk A, Guven M, Celik I, Doganay M, Voss A.Importance of structured training programs and good role models in hand hygiene in developing countries. J Infect Public Health 2011;4 :80-90.
19. Bhattacharya S. Is screening patients for antibiotic-resistant bacteria justifiable in the Indian context? Indian J Med Microbiol 2011;29: 213–7.
20. Gastmeier P, Schwab F, Chaberny I, Geffers C.Individual units rather than entire hospital as the basis for improvement: the example of two Methicillin resistant Staphylococcus aureus cohort studies.Antimicrob Resist Infect Control 2012;1: 8.
21. You JH, Chan CY, Wong MY, Ip M. Active Surveillance and Decolonization of Methicillin-Resistant Staphylococcus aureus on Admission to Neonatal Intensive Care Units in Hong Kong: A Cost-Effectiveness Analysis.Infect Control Hosp Epidemiol 2012;33: 1024-30.
22. Ling ML, How KB.Impact of a hospital-wide hand hygiene promotion strategy on healthcare-associated infections.Antimicrob Resist Infect Control 2012;1 : 13