Colonization by methicillin resistant staphylococcus aureus among health care workers in intensive care units

ABSTRACT

Intensive care units [ICUs] are important breading ground for the development and spread of antibiotic resistant bacteria. The risk of exposure for health care workers [HCWs] to a specific pathogen is probably related to the prevalence of the implicated pathogen in patient population or the environment. This study aimed to describe the pattern of colonization with MRSA among HCWs in several ICUs of Suez Canal University Hospital [SCUH]; and search for finding any correlation between available infection control measures; the carriage rate of MRSA and testing the sensitivity of MRSA by cefoxitin disc against PCR method. The study involved 40 HCWs in four ICUs [Neonatal, Chest, Burn, Medical] of SCUH. They were Doctors 5 [12.5%], Nurses 25 [62.5%] and Workers 10 [25%]. Each participant completed a questionnaire and check list form. These showed suboptimal application of the infection control program and lapses in aspesis due to workload and limited resources. To detect MRSA colonization both nasal and nail bed swabs were collected from HCWs and inoculated on to Blood and Mannitol Salt Agar media. Testing for sensitivity to methicillin were performed by cefoxitin disc diffusion method [30 micro g] and by PCR method [gold standard for detection of MRSA]. The results of the two methods were the same and reflected that S. aureus isolated from 18[45%] HCWs 12[66.6%] were MRSA strains. The over all MRSA carriage rate was 30% [25% Nasal 5% Nail bed]. Highest rate was in burn ICU followed by chest, medical and neonatal ICUs [44.4%, 33.3%, 25% and 14% respectively]. There was no correlation between infection control training, antibiotic intake, duration of work of HCWs and carriage rate of MRSA [P >0.5]. to conclude, the present study revealed that cefoxitin disc diffusion test was 100% sensitive and specific for detection of MRSA like PCR method and the initial education programs need to be followed by reinforcement and infection control staff showed evaluate intrahospital compliance