Objective: Hospital-acquired staphylococcal infections lead to increased morbidity, mortality and hospital costs. Nasal S.aureus carriers are mostly responsible for these infections. In this study we aimed to investigate nasal staphylococcal carriage in hospital staff, methicillin and mupirocin resistance in these strains and variation in respect to occupational groups and hospital units.
Material and Methods: A total of 104 hospital employees were screened by taking samples from anterior nares by cotton swabs soaked into saline. Specimens directly plated on 5% sheep blood agar. Samples were incubated for 24 hours at 37ºC. Bacterial identification was done by Standard microbiologic methods. Methicillin and mupirocin resistance were tested by disc diffusion method according to CLSI (Clinical and Laboratory Standards Institute) recommendations.
Results: Nasal swabs from 73 female (70.2%) and 31 male, (29.8%) with a total of 104 hospital employees were taken. S. aureus was isolated in 46 (44.2%) and coagulase-negative staphylococci were isolated in 54 (51.9%) of these samples. Methicillin-resistance was 30.4% in S. aureus and 33.3% in CNS strains. The prevalance of mupirocin-resistance was 22% when all strains were included and it increased to 28.6% in MRSA strains. When analyzed in respect to employee’s occupation type and place of work, methicillin-resistance was highest in intensive care unit staffs and unskilled (non-professional) workers.
Conclusion: Since carrier employees can cause hospital-acquired staphylococal infections, it is of paramount importance to assess carriage state of hospital staff, education and proper treatment of the carriers. The authors think that, to prevent development of mupirocin-resistance and treatment failures due to mupirocin-resistance, antibiotic susceptibility tests must be done and carriers must be treated accordingly.
Key Words: Nasal Staphylococcal Carriage; Methicillin Resistance; Mupirocin Resistance.
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