Nasal Colonisation of MRSA in Oral Cancer Patients in a Tertiary Care Hospital of Northern India

Abstract

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of healthcare-associated infection worldwide. Immunocompromised patients are more susceptible to develop infection from own colonised MRSA. Aim: To screen oral cancer patients for nasal colonisation of MRSA at two time point during study period. Materials and Methods: The study was conducted in SN Medical College, Agra for a period of six months. Anterior nares of 50 participants having oral cancer were screened for colonisation of Staphylococcus aureus. Isolates were identified as Staphylococcus aureus as per standard protocol and were further subjected to see the production of MRSA as per CLSI criteria. Results: Total 50 patients were enrolled in the study, out of these, 34 were put on chemotherapy while 16 were put on radiotherapy. Before starting any treatment modality 29 (58%) patients were colonised with Staphylococcus aureus out of which 16 (32%) were MRSA strains and 13 (26%) were MSSA. Patients who did not show MRSA colonisation in their anterior nares (34/50; 68%) were further screened for MRSA colonisation after three weeks of chemotherapy and four weeks of radiotherapy. 50% patients (7/14) of chemotherapy group demonstrated the conversion of nasal flora in MRSA after three weeks of treatment and 33.3% (3/9) of radiotherapy group showed the conversion in MRSA after four weeks of treatment. Conclusion: The present study suggests that if a patient is colonised initially with MSSA in oral cancer patient then the patient should not be left as non MRSA producer. As patient might develop MRSA colonisation after chemotherapy and radiotherapy which may further be the reason for resistant infection in immune-compromised cancer patients.

Keywords

• immunocompromised patients
• methicillin resistance
• staphylococcus