Increased Incidence of Methicillin Resistant and Methicillin Resistant in the Skin and Nasal Carriage Among Healthcare Workers and Inanimate Hospital Surfaces After the COVID-19 Pandemic

Overview

Journal Iran J Microbiol

Publisher Tehran University of Medical Sciences

Specialty Infectious Diseases

Date 2024 Nov 13

PMID 39534286

Authors

Esraa H Al-Nsour

Hadeel T Al-Hadithi

Rania Mhammad Al-Groom

Saqr Abushattal

Abdallah Y Naser

Ahmad H Al Nsour

Rawand A Sallam

Lara M Kollab

Laila Alswalha

Mohd Sajjad Ahmad Khan

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Healthcare workers in hospitals are exposed to infectious diseases that occur in the hospital making them a source of infection for the patients. It is interfaced as cross-contamination agents for MRSA and MR-CoNS, and preventive measures need to be adapted accordingly. The study aimed to assess Methicillin-Resistant Staphylococcus (MRS) on the skin and nasal cavities of healthcare workers (HCWs) and identifying isolates to the species level.

Materials And Methods: Swab samples were cultured on mannitol salt agar (MSA) to obtain MRS and determine their ability to produce coagulase. Their susceptibility to antibiotics were determined by agar screening and disk diffusion methods and further identification was done at the species level.

Results: The highest percentage of methicillin resistant coagulase positive Staphylococci (MRCoPS) was reported among skins of male HCWs, (71.4%) were identified as MRSA. The highest levels of methicillin resistant coagulase negative Staphylococci (MRCoNS) were mainly detected in both nasal cavities, (75%) were identified as MRSE. MRSA was reported from doctors (p-value 0.033), whereas the highest incidence of MRSE was obtained from the nurses (p-value 0.048).

Conclusion: This study highlighted that incidence of MRSA was mainly detected in doctors and MRCoNS in both nasal cavities. The highest percentage of MRCoNS was recovered from the patients' room followed by the reception table. Moreover, vancomycin is suggested to be highly effective in managing and controlling , MRSA- and MRSE related infections.

Citing Articles

Bacterial Infections, Trends, and Resistance Patterns in the Time of the COVID-19 Pandemic in Romania-A Systematic Review.

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PMID: 39766609 PMC: 11726834. DOI: 10.3390/antibiotics13121219.

References

Behshood P, Tajbakhsh E, Momtaz H . Recognition of (Sesc) for Easy Identification of and Molecular and Phenotypic Study of Β-Lactam Resistance in Isolates in Isfahan. Rep Biochem Mol Biol. 2021; 9(3):309-314. PMC: 7816779. DOI: 10.29252/rbmb.9.3.309. View

Rossi C, Pereira M, Giambiagi-deMarval M . Underrated Staphylococcus species and their role in antimicrobial resistance spreading. Genet Mol Biol. 2020; 43(1 suppl 2):e20190065. PMC: 7198029. DOI: 10.1590/1678-4685-GMB-2019-0065. View

Mun Y, Kim M, Oh J . Ten-year analysis of microbiological profile and antibiotic sensitivity for bacterial keratitis in Korea. PLoS One. 2019; 14(3):e0213103. PMC: 6396910. DOI: 10.1371/journal.pone.0213103. View

Xu Z, Shah H, Misra R, Chen J, Zhang W, Liu Y . The prevalence, antibiotic resistance and characterization of coagulase negative staphylococci recovered from non-healthcare settings in London, UK. Antimicrob Resist Infect Control. 2018; 7:73. PMC: 6000976. DOI: 10.1186/s13756-018-0367-4. View

Abimana J, Kato C, Bazira J . Methicillin-Resistant Nasal Colonization among Healthcare Workers at Kampala International University Teaching Hospital, Southwestern Uganda. Can J Infect Dis Med Microbiol. 2019; 2019:4157869. PMC: 6431477. DOI: 10.1155/2019/4157869. View

Giri N, Maharjan S, Thapa T, Pokhrel S, Joshi G, Shrestha O . Nasal Carriage of Methicillin-Resistant among Healthcare Workers in a Tertiary Care Hospital, Kathmandu, Nepal. Int J Microbiol. 2021; 2021:8825746. PMC: 8373499. DOI: 10.1155/2021/8825746. View

Tajeddin E, Rashidan M, Razaghi M, Javadi S, Sherafat S, Alebouyeh M . The role of the intensive care unit environment and health-care workers in the transmission of bacteria associated with hospital acquired infections. J Infect Public Health. 2015; 9(1):13-23. DOI: 10.1016/j.jiph.2015.05.010. View

Efa F, Alemu Y, Beyene G, Gudina E, Kebede W . Methicillin-resistant carriage among medical students of Jimma University, Southwest Ethiopia. Heliyon. 2019; 5(1):e01191. PMC: 6360348. DOI: 10.1016/j.heliyon.2019.e01191. View

Salman M, Sohail Ashraf M, Iftikhar S, Baig M . Frequency of nasal carriage of among health care workers at a Tertiary Care Hospital. Pak J Med Sci. 2018; 34(5):1181-1184. PMC: 6191800. DOI: 10.12669/pjms.345.14588. View

10.

Barbier F, Ruppe E, Hernandez D, Lebeaux D, Francois P, Felix B . Methicillin-resistant coagulase-negative staphylococci in the community: high homology of SCCmec IVa between Staphylococcus epidermidis and major clones of methicillin-resistant Staphylococcus aureus. J Infect Dis. 2010; 202(2):270-81. DOI: 10.1086/653483. View

11.

Mollers M, von Wahlde M, Schuler F, Mellmann A, Boing C, Schwierzeck V . Outbreak of MRSA in a Gynecology/Obstetrics Department during the COVID-19 Pandemic: A Cautionary Tale. Microorganisms. 2022; 10(4). PMC: 9024722. DOI: 10.3390/microorganisms10040689. View

12.

Bari M, Haque N, Khan R, Haque S, Kabir M, Yasmin T . Methicillin resistant Staphylococcus epidermidis. Mymensingh Med J. 2011; 20(2):326-31. View

13.

Polly M, de Almeida B, Lennon R, Cortes M, Costa S, Guimaraes T . Impact of the COVID-19 pandemic on the incidence of multidrug-resistant bacterial infections in an acute care hospital in Brazil. Am J Infect Control. 2021; 50(1):32-38. PMC: 8457917. DOI: 10.1016/j.ajic.2021.09.018. View

14.

Pourmand M, Hassanzadeh S, Mashhadi R, Askari E . Comparison of four diagnostic methods for detection of methicillin resistant Staphylococcus aureus. Iran J Microbiol. 2015; 6(5):341-4. PMC: 4385575. View

15.

Zhanel G, Adam H, Baxter M, Fuller J, Nichol K, Denisuik A . 42936 pathogens from Canadian hospitals: 10 years of results (2007-16) from the CANWARD surveillance study. J Antimicrob Chemother. 2019; 74(Suppl 4):iv5-iv21. DOI: 10.1093/jac/dkz283. View

16.

Giske C, Turnidge J, Canton R, Kahlmeter G . Update from the European Committee on Antimicrobial Susceptibility Testing (EUCAST). J Clin Microbiol. 2021; 60(3):e0027621. PMC: 8925892. DOI: 10.1128/JCM.00276-21. View

17.

Price J, Cole K, Bexley A, Kostiou V, Eyre D, Golubchik T . Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing. Lancet Infect Dis. 2016; 17(2):207-214. PMC: 5266793. DOI: 10.1016/S1473-3099(16)30413-3. View

18.

El Aila N, Al Laham N, Ayesh B . Nasal carriage of methicillin resistant Staphylococcus aureus among health care workers at Al Shifa hospital in Gaza Strip. BMC Infect Dis. 2017; 17(1):28. PMC: 5217237. DOI: 10.1186/s12879-016-2139-1. View

19.

Kateete D, Kimani C, Katabazi F, Okeng A, Okee M, Nanteza A . Identification of Staphylococcus aureus: DNase and Mannitol salt agar improve the efficiency of the tube coagulase test. Ann Clin Microbiol Antimicrob. 2010; 9:23. PMC: 2927478. DOI: 10.1186/1476-0711-9-23. View

20.

Seng R, Kitti T, Thummeepak R, Kongthai P, Leungtongkam U, Wannalerdsakun S . Biofilm formation of methicillin-resistant coagulase negative staphylococci (MR-CoNS) isolated from community and hospital environments. PLoS One. 2017; 12(8):e0184172. PMC: 5578677. DOI: 10.1371/journal.pone.0184172. View