Methicillin and mupirocin resistance in nasal colonizers coagulase-negative Staphylococcus among health care workers

• Main Authors: Loveleena Agarwal, Amit Kumar Singh, Anjali Agarwal, Amitabh Agarwal
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Medical Journal of Dr. D.Y. Patil University
• Subjects: Coagulase-negative Staphylococcus; methicillin-resistant coagulase-negative Staphylococcus; mupirocin-resistant coagulase-negative Staphylococcus
• Online Access: http://www.mjdrdypu.org/article.asp?issn=0975-2870;year=2016;volume=9;issue=4;spage=479;epage=483;aulast=Agarwal

Objective: Coagulase-negative Staphylococcus (CoNS) is a harmless commensal flora of human body but may cause infections related to medical device implant, blood stream infections, and infections of newborns. Health care workers (HCWs) colonizing methicillin-resistant CoNS (MRCoNS) may help in transmission of the microorganism and thus leads to the development of infection. The purpose of this study was to determine the prevalence of methicillin and mupirocin resistance in CoNS as nasal colonizer among HCWs and its antimicrobial susceptibility pattern. Materials and Methods: Nasal swabs collected from 210 HCWs of various categories such as doctor, nurse, nursing student, nursing orderlies, technician, and others working in the hospital were taken in equal representation. Methicillin resistance among the CoNS isolates was identified using cefoxitin 30 μg disc. Antimicrobial susceptibility profile of the isolates was also determined for several antibiotics. Mupirocin resistance was determined by epsilometer test using E-strip. Results: Of 210 nonduplicate nasal swabs collected from HCWs, 69 (32.8%) CoNS, and 16 (7.6%) MRCoNS isolates were obtained. A higher carrier rate of CoNS was found among nursing students (53%) with 50% MRCoNS as compared to other categories of HCWs. MRCoNS strains were significantly associated (P < 0.05) with resistance to most of the antibiotics with 100% resistance to penicillin and a higher resistance to rifampin (88%), clindamycin (69%), septran (63%), and erythromycin (56%). All CoNS isolates were uniformly susceptible to linezolid. Mupirocin resistance detected using E-strip showed 3 (1.4%) MRCoNS isolates had high-level resistance. Conclusion: MRCoNS showed a significant association of resistance to other antibiotics, thus methicillin and mupirocin resistance in CoNS must be detected in HCWs as a routine protocol of hospital infection control policy to limit nosocomial infections.