Nasal Colonization of Methicillin Resistant Staphylococcus aureus among Healthcare Providers in a Tertiary Care Hospital, Bangladesh.

ABSTRACT

Healthcare providers colonized with Staphylococcus aureus may transmit the organism to patients and community. This study was carried out to determine the rate of nasal colonization of Methicillin resistant Staphylococcus aureus (MRSA) and Vancomycin resistant Staphylococcus aureus (VRSA) among healthcare providers. This cross sectional study was conducted among healthcare providers in a tertiary care hospital, Bangladesh. Nasal swabs from anterior nares of 250 physicians, nurses, and helping staffs working in Dhaka Medical College Hospital were analyzed. Methicillin resistance among MRSA was detected by disc diffusion technique using oxacillin, cefoxitin disc and MIC of oxacillin and methicillin resistance was confirmed by PCR detecting mec-A gene. Considering PCR for mec-A gene as gold standard the sensitivity and specificity of both cefoxitin disc diffusion method and MIC of oxacillin was 100%. Cefoxitin disc diffusion method was better alternative of oxacillin disc diffusion method for detection of MRSA. Nasal colonization by S. aureus was found among 23.2% healthcare providers and 7.2% were colonized with MRSA and no VRSA was detected. MRSA colonization was detected among 5% physicians, 6.43% nurses and 16.67% of helping staffs. Isolated MRSA strains were highly resistant to ciprofloxacin (88.9%), gentamicin (77.8%), erythromycin (72.2%) and Co-trimoxazole (72.2%). All the isolated MRSA were sensitive to linezolid and vancomycin. Periodic screening of healthcare providers should be done to find out MRSA carrier and should be treated accordingly to terminate chain of transmission of the multi-drug resistant organism.