Carriage of Methicillin Resistant Staphylococcus aureus amongst Theater/Intensive Care Unit Workers in a Tertiary Healthcare Center in Nigeria: FMC Owerri Experience

Background:In recent years nosocomial outbreaks of methicillin and multiple-antibiotic-resistant Staphvlococcus aureus (MRSA) have become a major infection control problem. S. aureus is ubiquitous and can easily colonize individuals leading to the potential for rapid spread. Antibiotic resistance is also a concern with this bacterium particularly the MRSA. The screening and eradication of MRSA from the colonized HCWs has been recognized and recommended as an important part of a comprehensive infection control policy for this organism. This study was therefore aimed at establishing the carriage rate of MRSA among the HCWs in the 6 bedded critical care units and newly commissioned six- suite operating theatre of FMC Owerri. Materials and Method: Nasal swabs and swabs of the webs of the digits were collected from all recruited staff for microscopy, culture. The specimens were inoculated on selective and non selective media. The specimen was inoculated on MacConkey agar and blood agar and incubated at 35-37°C for 18-24hrs. Staphylococcus aureus grew on MacConkey agar appearing as a lactose fermenter and on blood agar as golden colonies. Antibiotic Susceptibility Testing was done using the disc diffusion method (Modified Kirby-Bauer test). Results: A total of 32 staff were screened for carriage of Methicillin Resistant Staphylococcus aureus, 15 (46.9%) were male and 17 (53.1%) were female. Twelve were physicians (37.5%), 15(46.9%) were nurses and 5(15.6%) were attendants. The results of cultures revealed that 20.3% of isolates recovered. The susceptibility of the fourteen MRSA isolates yielded the following results: 83.4% were resistant to Amoxicillin-clavulanate, 57.2% were resistant to chloramphenicol, 42.8% were resistant to Gentamicin and Erythromycin, 14.2% were resistant to ciprofloxacin, 21.2% resistant to ceftriaxone, 35% were resistant to Levofloxacin, and 28.5% were resistant to Ofloxacin. Conclusion, the prevalence of MRSA (20.3%) found in workers in the ICU may indicate the need for regular screening of healthcare workers in this setting and the development of control measures to mitigate any colonization. These solutions may require both short- and long-term planning and implementation, however, the reduction of hospital-acquired and iatrogenic infection spread, particularly in the ICU, may well be worth the effort.