Nasal Carriage of Staphylococci among Health Care Workers and Impact of Conventional Decolonisation Methods

Main Article Content

Chiranjib Das
Ranadeep Ghosh
Kingshuk Dhar

Abstract

Introduction


Staphylococci are one of the most common causes of nosocomial infections. The principal route of transmission of Staphylococci is the contaminated hands of health care workers (HCWs). Staphylococci can also be found as part of the nasal microbiota without causing overt disease. So we undertake the present study to estimate the prevalence of asymptomatic nasal carriage of Staphylococci among HCWs and impact of conventional decolonisation methods in a tertiary care hospital in West Bengal.


Materials and Methods


Nasal swabs were collected from anterior nares of HCWs for culture and antibiotic sensitivity test on day one. HCWs who were found to be carriers of Staphylococci were advised to apply mupirocin ointment to anterior nares twice daily along with chlorhexidinegluconate bath once daily for five days. All HCWs were also advised to practice standard hygiene protocol. All of them were re-tested for nasal swab culture and antibiotic sensitivity on day seven and day twenty eight.


Results


Nasal carriage of Staphylococci in the first, second and third culture report was found to be 64.28%, 7.14% and 24.49% respectively. Cefotaxime, cotrimoxazole and erythromycin were least effective against Staphylococci. There was variable sensitivity to clindamycin, gentamycin and ciprofloxacin. All strains of Staphylococci were highly sensitive to linezolid. All strains of Staphylococci except MRSA were highly sensitive to vancomycin.


Conclusion


The present study re-establishes the fact that HCWs carry Staphylococci in their nose in significantly high proportion. So different measures should be undertaken to minimise Staphylococci related nosocomial infections.

Article Details

How to Cite
1.
Das C, Ghosh R, Dhar K. Nasal Carriage of Staphylococci among Health Care Workers and Impact of Conventional Decolonisation Methods. BJOHNS [Internet]. 2021Jun.3 [cited 2024Nov.21];29(1):28-35. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/426
Section
Main article
Author Biographies

Ranadeep Ghosh, Associate Professor, Department of Microbiology, Maharaja Jitendra Narayan Medical College and Hospital, Cooch Behar, West Bengal

Associate Professor, Department of Microbiology, Maharaja Jitendra Narayan Medical College and Hospital, Cooch Behar, West Bengal

Kingshuk Dhar, Assistant Professor, Department of Microbiology, Maharaja Jitendra Narayan Medical College and Hospital, Cooch Behar, West Bengal

Assistant Professor, Department of Microbiology, Maharaja Jitendra Narayan Medical College and Hospital, Cooch Behar, West Bengal

References

Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004; 39:309-17

Solberg CO. Spread of Staphylococcus aureus in hospitals: causes and prevention. Scand J Infect Dis. 2000; 32:587-95

Cookson B, Peters B, Webster M, Phillips I, Rahman M, Noble W. Staff carriage of epidemic methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 1989; 27:1471-6

David MZ, Daum RS. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev. 2010; 23:616-87

S. Bruzzese , K. Bush , J. Leal , J. Kim , D.M. Vickers , A. Rusk , et al. Comparing the epidemiology of hospital-acquired methicillin-resistant Staphylococcus aureus clone groups in Alberta, Canada. Epidemiol. Infect. 2016;144(10);2184-90

Sefani, S and Varaldo, P.E. Epidemiology of methicillin resistant staphylococci in Europe. Clin. Microbiol. Infect. 2003,9:1179-86

Hurdle, J.G, O’Neill, A.J, Mody, L, Chopra, I and Bradely, S.F. In vivo transfer of high level mupirocin resistant Staphylococcus aureus associated with failure of mupirocin prophylaxisis. J. Antimicrob. Chemother. 2005,56:1166-8

Albrich WC, Harbarth S. Health-care workers: source, vector, or victim of MRSA? Lancet Infect Dis. 2008;8:289-301

Nadia. E. Al-Abdli, and Saleh.H. Baiu, “Nasal Carriage of Staphylococcus in Health Care Workers in Benghazi Hospitals.” American Journal of Microbiological Research 2014; 2(4): 110-2

Na’was T, Fakhoury J. Nasal carriage of methicillin-resistant Staphylococcus aureus by hospital staff in north Jordan. J Hosp Infect. 1991; 17:223-9

AkouaKoffi C, Dje K, Toure R. Nasal carriage of methicillin resistant Staphylococcus aureus among health care personnel in Abidjan (Cote d’Ivoire). Dakar Med. 2004;49:70-4

Shibabaw A, Abebe T, Mihret A. Nasal carriage rate of methicillin resistant Staphylococcus aureus among Dessie Referral Hospital Health Care Workers; Dessie, Northeast Ethiopia. Antimicrobial Resist Infect Control. 2013; 2:25

Perl TM, Cullen JJ, Wenzel RP, Zimmerman MB, Pfaller MA, Sheppard D, Twombley J, French PP, Herwaldt LA. Mupirocin and the Risk of Staphylococcus aureus Study Team. Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. N Engl J Med. 2002;346:1871-7

Wertheim HF, Melles DC, Vos MC, et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis. 2005;5:751-62

Kaiser AB, Kernodle DS, Barg NL, Petracek MR. Influence of preoperative showers on staphylococcal skin colonization: a comparative trial of antiseptic skin cleansers. Ann Thorac Surg. 1988;45:35-8

Van Rijen M, Bonten M, Wenzel R, Kluytmans J. Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD006216. doi: 10.1002/14651858.CD006216.pub2

Septimus EJ, Schweizer ML. Decolonization in Prevention of Health Care-Associated Infections. Clin Microbiol Rev. 2016; 29(2):201-22. doi: 10.1128/CMR.00049-15

Lowy, F. D. 1998. Staphylococcus aureus infections. N Engl J Med. 1998;339:520-32.

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