Evaluation of Methicillin Resistant Staphylococcus Aureus Colonization in Patients and Nursing Staff of Intensive Care Units of A Tertiary Care Hospital in A Rural Area

• Main Authors: Rajesh Bareja, Kanu Goel, Shinu Pottathil, Vinod Kumar Narang, Varsha Ashok Singh, Prem Singh Grover
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2013-10-01
• Series: National Journal of Laboratory Medicine
• Subjects: cefoxitin disk; icu; mrsa; oxacillin salt agar
• Online Access: http://www.njlm.net/articles/PDF/1996/5-6900_E(_)_F(H)_PF1(SH)_PFA(H).pdf

Context: Methicillin resistant Staphylococcus aureus (MRSA) is an increasing problem in health care facilities. Rising colonization rates lead to increased infection rates in the community and in hospitals. MRSA infection in critically ill patients is associated with prolonged intensive care unit stay, increased medical cost and high mortality. Aim: The prevalence and rate of acquisition of methicillinresistant S. aureus in nursing staff and patients admitted to the intensive care units (ICUs) were studied in order to estimate the possible risk for those, who are initially free of the organism, of acquiring MRSA infection while maintained in the ICU. Settings and Design: This was a cross sectional study conducted in the Department of Microbiology, M.M.I.M.S.R. Mullana, Ambala, Haryana, India. Material and Methods: A total of 400 specimens of hands, throat and nares from the fifty patients and fifty nursing staff of ICUs were subjected to bacteriological examination. All the specimens were processed on blood agar and MacConkey agar then incubated at 37°C in incubator for 24 hours. Suspicious colonies were identified as Staphylococcus aureus by various biochemical tests. Methicillin resistant was confirmed with cefoxitin disk (30μg) susceptibility test and Oxacillin Salt Agar method. Results: Of these, 234 (58.5%) isolates were found to be positive for MRSA. MRSA strains isolated from hands, throat and nares of patients and nursing staff were 74 (37%) and 78 (39%), 39 (39%) and 41 (41%), 2 (2%) and 0% respectively. Surgery ICU had the highest burden (30.25%) followed by Medicine ICU (17.75%) and Paediatric ICU (10.5%). Antibiotic sensitivity testing identified 31.63% MRSA strains to be resistant to vancomycin. Conclusion: The results indicate, screening of ICU staff and patients for methicillin resistant S. aureus colonization and infection, accompanied by antibiotic sensitivity testing of cultured isolates, is important to understand its epidemiology and to develop preventive measures and treatment strategies