Khatri S, Pant N D, Bhandari R, Shrestha K L, Shrestha C D, Adhikari N, Poudel A
Department of Microbiology, Goldengate International College, Kathmandu, Nepal.
Department of Microbiology, Grande International Hospital, Kathmandu, Nepal.
J Nepal Health Res Counc. 2017 Jan;15(1):26-30. doi: 10.3126/jnhrc.v15i1.18009.
Methicillin-resistant Staphylococcus aureus is one of the most common causes of nosocomial infections. Due to its multidrug resistant nature; infections due to Methicillin-resistant Staphylococcus aureus are often very difficult to treat. Colonized health care workers are the important sources of Methicillin-resistant Staphylococcus aureus. The objectives of this study were to determine the nasal carriage rate of Methicillin-resistant Staphylococcus aureus among health care workers at Kathmandu Medical College and Teaching Hospital, Nepal and to assess their antimicrobial susceptibility patterns.
A cross sectional study was conducted among 252 health care workers from July to November 2013. Mannitol salt agar was used to culture the nasal swabs. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion technique following Clinical and Laboratory Standards Institute guidelines. Methicillin-resistant Staphylococcus aureus strains were confirmed by using cefoxitin disc and by determining the minimum inhibitory concentration of oxacillin by agar dilution method.
Of 252 healthcare workers, 46(18.3%) were positive for Staphylococcus aureus among which 19(41.3%) were Methicillin-resistant Staphylococcus aureus carriers. Overall rate of nasal carriage of Methicillin-resistant Staphylococcus aureus was 7.5% (19/252).The higher percentages of lab personnel were nasal carriers of S. aureus (31.6%) and Methicillin-resistant Staphylococcus aureus (10.5%).The percentages of nasal carriage of S. aureus (35.7%) and Methicillin-resistant Staphylococcus aureus (14.3%) were highest in the health care workers from post operative department. Higher percentage of Methicillin-resistant Staphylococcus aureus were susceptible toward amikacin (100%) and vancomycin (100%) followed by cotrimoxazole (84.2%).
High rates of nasal carriage of S. aureus and Methicillin-resistant Staphylococcus aureus were observed among the healthcare workers, which indicate the need of strict infection control measures to be followed to control the nosocomial infections.
耐甲氧西林金黄色葡萄球菌是医院感染最常见的病因之一。由于其多重耐药性，耐甲氧西林金黄色葡萄球菌引起的感染往往很难治疗。定植的医护人员是耐甲氧西林金黄色葡萄球菌的重要来源。本研究的目的是确定尼泊尔加德满都医学院和教学医院医护人员中耐甲氧西林金黄色葡萄球菌的鼻腔携带率，并评估其抗菌药敏模式。
2013年7月至11月对252名医护人员进行了横断面研究。用甘露醇盐琼脂培养鼻拭子。按照临床和实验室标准研究所的指南，采用 Kirby-Bauer 纸片扩散法进行抗菌药敏试验。通过使用头孢西丁纸片并通过琼脂稀释法测定苯唑西林的最低抑菌浓度来确认耐甲氧西林金黄色葡萄球菌菌株。
在252名医护人员中，46人（18.3%）金黄色葡萄球菌检测呈阳性，其中19人（41.3%）是耐甲氧西林金黄色葡萄球菌携带者。耐甲氧西林金黄色葡萄球菌的总体鼻腔携带率为7.5%（19/252）。实验室工作人员中金黄色葡萄球菌（31.6%）和耐甲氧西林金黄色葡萄球菌（10.5%）的鼻腔携带者比例更高。术后科室医护人员中金黄色葡萄球菌（35.7%）和耐甲氧西林金黄色葡萄球菌（14.3%）的鼻腔携带率最高。较高比例的耐甲氧西林金黄色葡萄球菌对阿米卡星（100%）和万古霉素（100%）敏感，其次是复方新诺明（84.2%）。
医护人员中观察到较高的金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌鼻腔携带率，这表明需要采取严格的感染控制措施来控制医院感染。
