Surveillance of health-care workers hand to detect carriage of multidrug-resistant Staphylococcus spp. in a tertiary care center: An observational study

Abstract

Objective: Healthcare-associated infection (HCAI) has become a potential peril in intensive care unit (ICU), operation theater (OT) as well as postoperative wards. Those infections are often caused by multidrug-resistant (MDR) organisms. Health-care workers (HCWs), who are taking care of sick patients, often colonize and transmit microorganism from infected to noninfected patient causing HCAIs. The purpose of this study was for surveillance of potential pathogens as hand carriage among HCWs. Materials and Methods: Hand swabs were collected from palmar surface and interdigital space of predominant hands of HCWs working in ICU, OT, and postoperative wards. Antimicrobial susceptibility profile of the potential pathogen isolates including Staphylococcus spp. was also determined for several antibiotics. Methicillin resistance was detected using cefoxitin 30 μg disc. Results: In our study, among 199 HCWs, there was a high carriage rate of Staphylococcus spp. in hands 98 (49.2%) (male: female 1:1). Among Staphylococcus spp., Coagulase-negative staphylococci (CoNS) was around 69 (34.6%) and Staphylococcus aureus was around 29 (14.5%). (including methicillin-resistant S. aureus [MRSA] and methicillin-resistant coagulase-negative Staphylococci [MR-CoNS]). Nearly 65% in MRSA and 75% MR-CoNS were macrolide resistant also. The MRSA hand carriage was significantly high in HCWs having <10 years of service (P = 0.035). No Gram-negative bacteria were identified. Nearly 54 (27%) HCWs were found to be noncarriers (sterile). Conclusion: In our tertiary care center, hand carriage of potential pathogens such as MDR Staphylococcus spp. was very high among HCWs.

Keywords

• hand carriage
• health-care workers
• multidrug resistance
• staphylococcus spp