Journal of Krishna Institute of Medical Sciences University (Apr 2022)
Mupirocin resistance in methicillin-resistant Staphylococcus aureus isolates from anterior nares of healthcare workers of a tertiary care hospital
Abstract
Background: Nasal colonization of Staphylococcus aureus is very common among health care workers, as part of a comprehensive Methicillin Resistant Staphylococcus aureus (MRSA) decolonization strategy, Mupirocin (Pseudomonic acid) is a topical antibiotic largely used to eradicate staphylococcal nasal carriage. Increased mupirocin use predisposes to mupirocin resistance, which is significantly associated with persistent MRSAcarriage. This resistance is both low level as well as high level among the isolated strains. Aim and Objectives: To estimate the nasal carriage of MRSA in Healthcare Workers (HCWs) and to detect level of Mupirocin resistance in isolated MRSA strains. Material and Methods: A total 670 nasal swabs of HCWs (doctors, nursing staff and housekeeping staff) from various high risk areas were tested. High level and low level Mupirocin resistance among the isolated MRSA strains was detected by Kirby Bauer disc diffusion method. Minimum Inhibitory Concentration (MIC) of Mupirocin resistance was determined by E test. Results: Among 670 nasal swabs, 280 (41.79 %) showed growth of Staphylococcus aureus and 353 (52.68%) were Coagulase Negative Staphylococci (CONS). Of 280 Staphylococcus aureus strains, 61 (21.78%) strains were methicillin-resistant (MRSA). Mupirocin resistance both low level and high level was observed in 1 (1.63%) MRSAcarrier only. Conclusion: The present study showed a high incidence of nasal carriage of MRSA among health care workers. Therefore we suggest MRSA screening of HCWs as a routine practice and insist on Mupirocin resistance detection so that in case if resistance detected alternative treatment can be given.
