Infection and Drug Resistance (Aug 2021)
Methicillin-Resistant Staphylococcus aureus Nasal Colonization Among Health Care Workers of a Tertiary Hospital in Ecuador and Associated Risk Factors
Abstract
Isabel Baroja,1,2 Sara Guerra,1,2 Marco Coral-Almeida,3 Alejandra Ruíz,2,4,5 Juan Miguel Galarza,2,6 Jacobus H de Waard,7 Carlos Bastidas-Caldes1,7,8 1Facultad de Ingenierías y Ciencias Aplicadas, Biotecnología, Universidad de Las Américas, Quito, Ecuador; 2Unidad Técnica de Genética Molecular, Hospital de Especialidades Carlos Andrade Marín, Quito, Ecuador; 3Grupo de Bio-Quimioinformatica, Facultad de Ciencias de la Salud, Universidad de Las Américas, Quito, Ecuador; 4IESS Quito Sur General Hospital, Institutional Coordination of Epidemiological Surveillance and Infectology, Molecular Microbiology, Quito, Ecuador; 5Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador; 6Unidad de Biociencias, Gerencia de Molecular y Oncodiagnóstico, SIMED S.A., Quito, Ecuador; 7One Health Research Group, Facultad de Ingenierías y Ciencias Aplicadas, Biotecnología, Universidad de Las Américas, Quito, Ecuador; 8Programa de Doctorado en Salud Pública y Animal, Universidad de Extremadura, Extremadura, EspañaCorrespondence: Carlos Bastidas-CaldesOne Health Research Group, Facultad de Ingenierías y Ciencias Aplicadas, Biotecnología, Universidad de Las Américas, Quito, EcuadorTel +593 983 174949Email [email protected]; [email protected]: Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to most of the commonly used antibiotics and is therefore a public health issue. Colonization with MRSA is a risk factor for infection or transmission.Purpose: To determine the prevalence of colonization with Staphylococcus aureus (SA) and MRSA strains in health care workers (HCWs) at a tertiary hospital in Ecuador and to determine the risk factors associated with carriage.Methods: Out of a cohort of 3800 HCWs, 481 individuals from different hospital departments were randomly selected, and a single nasal swab was collected. Detection of SA and MRSA was carried out with the LightCycler® MRSA Advanced Test. A questionnaire was performed that gathered demographic and occupational information of the participants to determine risk factors for MRSA colonization. Statistical analysis was performed with univariate and multivariate analysis and the R-software version 4.0.2.Results: Colonization with SA and MRSA occurred in respectively 23.7% (95% CI, 22.7– 24.6) and 5% (95% CI, 3.39– 7.58) of the individuals. The multivariate analysis showed that being older in age (OD 1.09) and being male (OD 2.78) were risk factors for SA and MRSA colonization (p-value < 0.001). Previous use of antibiotics or the use of nasal ointments diminished the colonization rates of SA (24% versus 3.7% and 10.1% respectively).Conclusion: About 20% of the HCWs who were colonized with SA were colonized with MRSA, representing a risk for nosocomial infections and hospital outbreaks. Active monitoring and a decolonization treatment of the HCWs can reduce these risks.Keywords: Staphylococcus aureus, SA, antibiotic resistance, methicillin-resistant Staphylococcus aureus, MRSA, health care workers, HCWs, colonization, risk factors
