Molecular characterization and antibiotic susceptibility pattern of methicillin-resistant S. aureus [MRSA] in tertiary care hospital, Kashan

Methicillin resistant Staphylococcus aureus [MRSA], which is the most common cause of nosocomial infection, has been a major cause of morbidity and mortality around the world. This study was carried out to find out the resistance pattern and staphylococcal cassette chromosome mec [SCCmec] typing among MRSA. This descriptive work was done on 87 Methicillin resistant Staphylococcus aureus isolates which were collected from the patients with infections in a teaching hospital in Kashan, Iran, during the period of 2009. The isolates were tested for antibiotic resistance by the disc-diffusion method, covering 10 antimicrobials. The genotypes of SCCmec subtypes were determined by multiplex PCR. Amomg 87 MRSA isolated tested; the highest resistance was shown against erythromycin, clindamycin, sulfamethoxazole-trimethoprim, and tetracycline respectively. By contrast, the highest sensitivity was shown to amikacin. All of the isolates were resistant to Beta-lactams. All of the isolates were resistant to at least three classes of antibiotics, and all of the isolates were sensitive to vancomycin. Three [3.4%] MRSA strains were SCCmec type I, 12 [13.8%] were type II, 8 [9.2%] were type IV-b, 4 [4.6%] were type IV-d, and 3 [3.4%] were typeV. Overall, 57 [65.5%] MRSA strains could not be typed. The rising trend of multi-resistance to antibiotics poses an alarming threat to treatment of MRSA infections. Our findings show that clinical isolates of MRSA in our hospital carrying various kinds of staphylococcal cassette chromosome mec [SCCmec] types. SCCmec typse II and IV were the predominant strain of MRSA identified

Fear of being at risk of acquiring HIV, willingness to care, and discrimination in care and treatment of AIDS patients among nurses

Exposure to infectious blood and body fluids increase risk of occupationally acquired HIV among nurses. Discrimination in care and treatment of AIDS patient is one of the challenging ethical issues in nursing. The aim of this study was to determine fear of being at risk of acquiring HIV, willingness to care, and discrimination in care and treatment of AIDS patients among nurses. In this descriptive -cross sectional study, 165 nurses of internal and infectious wards from four selected hospitals of Tehran and Shahid Beheshti University of Medical Sciences participated. Data were collected by self-administered questionnaires. The instruments used included [demographic data form], [risk perception scale], [willingness to care for people living with HIV/AIDS]questionnaire, and [discrimination against AIDS] questionnaire. Data were analyzed by using SPSS 14, t-test, and pearson correlation. Out of 165 nurses, 36.4% had sever fear of being at risk of acquiring HIV, 81.8% were evaluated to be neutral in willingness to care of AIDS patients, and 54.5% agreed with moderately discrimination practice against AIDS patients. There was a significant correlation between fear of being at risk of acquiring HIV with discrimination in care and treatment of AIDS patients [p=0. 003] and willingness to care [p= 0.007]. It seems that education efforts about universal precautions, ethical issues, and patient rights should be made in order to reduce fear of being at risk of acquiring HIV, decrease discrimination in care and treatment of AIDS patients and increase willingness to care

[Nurse's perspective about discrimination in nursing care of patients with AIDS]

Discriminatory practices toward patients with AIDS is an important challenge in the context of ethical care and patient's rights. Experience of discrimination has negative impacts on the psychological well being of patient's and all aspects of AIDS prevention, follow-up care and treatment. The aim of this study was to identify nurse's perspective on discrimination in nursing care of patients with AIDS and its related factors. It was a descriptive cross-sectional study. The study population consisted of nurses working in internal and infectious wards. The setting was hospitals affiliated with Tehran and Shahid Beheshti University of Medical Sciences .the sample was recruited by census and 165 nurses were selected. Data was collected using self administered questionnaires. The instruments used included: discrimination against AIDS questionnaire, HIV knowledge questionnaire, AIDS Attitude Scale and Risk Perception scale. Data was analyzed by SPSS-PC using descriptive statistics, t-test, ANOVA and Pearson coefficient correlation. Response rate was 91.6% of all study sample, 54.5% agreed with present moderately discriminatory practices toward these patients. Nurse's perspective on discriminatory practices was significantly associated with their knowledge of AIDS transmission [p=0.005], avoidance attitudes toward people with AIDS [p=0.044], and fear of occupational exposure to AIDS [p=0.003].There was a significant difference between mean score of nurses perspective on discrimination with their sex [p=0.033], ward [0.036], and their educational level [p=0.048]. It seems that patients with AIDS in Tehran hospitals are treated with discrimination. Reducing discriminatory practices toward these patients would be possible by increasing nurse's knowledge about universal precautions, ethical issues and patient's rights

[Molecular characterization and SCCmec typing in meticillin-resistant staphylococcus aureus isolated from clinical samples]

Methicillin-resistant Staphylococcus aureus [MRSA] is the main cause of hospital infection. The aim of present study was to investigate the molecular characteristics of Staphylococcus aureus [SA], to detect mecA gene, and to type SCCmec in the strains isolated from patients at Kashan Shahid Beheshti Hospital. This descriptive study was carried out on SA isolates [n=150] collected from the clinical samples at Kashan Shahid Beheshti Hospital, Iran during 2009. The identification of all tested isolates were confirmed using Gram's stain, coagulase, DNase and manitol salt agar. In addition, the genotypes of SCCmec in the MRSA isolates were determined by multiplex PCR. Eighty seven [58%] out of 150 SA isolates were confirmed as MRSA harboring mecA gene detected by PCR. Thirty four out of 87 [39.1%] were HA-MRSA and the remainig 53 [60.9%] were CA-MRSA. The multiplex PCR assay for SCCmec complex of MRSA strains [n=87] showed that 3[3.4%] samples were SCCmec type I, 12[13.8%] SCCmec type II, 8[9.2]% SCCmec type IVb, 4[4.6%] SCCmec type IVd and 3[3.4%] SCCmec type V. More than 50% of SA strains were positive for mecA gene and more than 60% of them were CA-MRSA. Moreover, SCCmec type II was the predominant strain of the identified MRSA