Nasal Carriage of MRSA Strains Among Hospital Employees in a Surgical Department
The aim of the study was to estimate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strain carriage among hospital employees who have contact with patients treated at the General and Vascular Surgery Teaching Hospital of the Capital Bródnowski Hospital. Comparison of the findings with results from similar studies performed in various medical centers around the world.
Material and methods. Using microbial cultures, we screened for nasal carriage of MRSA strains in hospital employees who have contact with patients at the General and Vascular Surgery Teaching Hospital. The medical and custodial staff of the Faculty of General and Vascular Surgery, Anesthesiology and Operating Suite were studied. If MRSA strains were present on bacterial cultures, identification of the strain was further confirmed using molecular methods, including reverse transcription polymerase chain reaction (RT-PCR). Examinations were performed in collaboration with the Department of Epidemiology and Clinical Microbiology of the National Medicines Institute.
Results. The carriage rate confirmed by molecular techniques was 4.5%. Confirmed cases of MRSA carriage in hospital staff underwent eradication with a five-day treatment scheme of intranasal 2% mupirocin ointment. Control results confirmed its effectiveness.
Conclusions. The prevalence of nasal carriage of MRSA among the medical and custodial staff screened was 4.5%. This prevalence of carriage among medical employees is similar to the rate of carriage in the general population. This finding suggests a low rate of bacterial transmission between the faculty, staff, and patients. Eradication of MRSA with the use of a five-day course of 2% intranasal mupirocin ointment is an effective method of controlling carriage among medical staff as well as among the general public.
Samet A, Arłukowicz E, Nowicki R i wsp.: Nosicielstwo Staphylococcus aureus w jamie nosowej jako czynnik ryzyka chorób skóry i zakażeń ogólnoustrojowych. Przew Lek 2003; 6 (9): 28-33.
Hassan K, Paturi A, Hughes C et al.: The prevalence of methicillin resistant Staphylococus aureus in orthopaedics in a non-selective screening policy. Surgeon 2008; 4 (6): 201-03.
Yano M, Doki Y, Inoue M: Preoperative Intranasal Mupirocin Oinment Significantly Reduces Postoperative Infection with Staphylococcus aureus In Patients Undergoing Upper Gastrointestinal Surgery. Surg Today, Jpn J Surg 2000; 30: 16-21.
Nicholson M, Huesman L: Controlling the usage of intranasal mupirocin does impact the rate of Staphylococcus aureus deep sternal wound infections in cardiac surgery patients. Am J Infect Control 2006; 34: 44-48.
Kluytmans JAJ, Mouton JW, Ijzerman EPF et al.: Nasal carriage of Staphylococcus aureus as a major risk factor for wound infections after cardiac surgery. JID 1995; 171: 216-19.
Cretnik TZ, Vovko P, Reteljet M et al.: Prevalence and nosocomial spread of methicillin-resistant Staphylococcus aureus in a long-term-care facility in Slovenia. Infect Control Hosp 2005; 26: 184-90.
Prados-Palos MA: Staphylococcus aureus e Staphylococcus aureus meticilina- resistentes (MRSA) em profissionais de saúde e as interfaces com as infecções nosocomiais. (Tese de Doutorado em Enfermagem), Universidade de São Paulo, Ribeirão Preto 2006.
Eveillard M, Martin Y, Hidri N et al.: Carriage of methicillin-resistant Staphylococcus aureus among hospital employees: prevalence, duration, and transmission to households. Infect Control Hosp Epidemiol 2004; 25: 114-20.
Wang JT, Lin SF, Chiu HL et al.: Molecular epidemiology and control of nosocomial methicillin-resistant Staphylococcus aureus infection in a teaching hospital. Formos Med Assoc 2004; 103: 32-36.
Nakamura MM, Rohling KL, Shashaty M et al.: Prevalence of methicillin-resistant Staphylococcus aureus nasal carriage in the community pediatric population. Pediatr Infect Dis J 2002; 21: 917-22.
Hryniewicz W: Postępy w mikrobiologii klinicznej w 2004 roku. Narodowy Instytut Zdrowia Publicznego w Warszawie. Med Praktyczna 2005/02, MP OnLine.
Gemmell CG, Edwards DI, Fraise AP et al.: Guidelines for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the UK. Warren on behalf of the Joint Working Party of the British Society for Antimicrobial Chemotherapy, Hospital Infection Society and Infection Control Nurses Association. Journal of Antimicrobial Chemotherapy 2006; 57: 589-608.