Original Articles

Investigating Colonization of Staphylococcus aureus among Patients Admitted to the Infectious Diseases Ward of Imam Hospital in Mashhad

Abstract

Introduction: Staphylococcus aureus colonization has been recognized as one of the most important risk factors for subsequent infections with this microorganism. In this study, we intended to identify all patients who were MRSA-positive upon admission and compare the prevalence of MRSA
colonization on different days of study admitted in Imam Reza hospital in Mashhad, Iran.
Methods: This cross-sectional study was done on 600 admitted patients in Infectious disease ward. Samples of patients were drawn from patients’ nares (and if they were culture negative, re-cultures were done on days 3, 7 and finally on discharge time. After identification of the isolates, their
susceptibility to methicillin was evaluated. Before we collect nasal swabs, patients filled out a survey questionnaire.
Results: S. aureus colonization early after hospitalization in infectious ward was observed in 39.8% (n=239) of patients, of which 59% (n=141) were resistant to methicillin. On the third day of admission, S. aureus new colonization rate was 15.8% (n=57), of which 87.7% (n=50) were methicillin resistant. On the seventh day, S. aureus were found in 13% (n=32) patients with 90.6% (n=29) were methicillin-resistant. Upon discharge, 8.2% (n=13) patients were S. aureus positive and 92.3% (n=12) were resistant to methicillin.
Conclusion: Most of the carriers had the methicillin resistant strains of bacteria at the time of admission, and the number of colonized patients with resistant bacteria increased in time. The most common risk factors in methicillin-resistant S. aureus carriers were taking antibiotic, history of prior
hospitalization and being an intravenous (IV) drug abuser.

Alavi SM, Rajabzadeh AR, Dezfoulian A, et al. Determination of nasal carriage of Staphylococcus aureus and antimicrobial resistance among hospital personal in Razi Hospital Ahwaz, Spring 2003. Scien Med J 2006; 5 (1): 378-384.

Sharifi M, Sarreshtehdari M, Hasani F, et al. Prevalence of and some risk factors for methicillin-resistant Staphylococcus aureus nasal colonization in hospitalized childern. Iran J Med Microbiol 2008-2009; 2 (3-4): 79-85.

Khalili MB, Sharifi-Yazdi MK, Dargahi H, et al. Nasal Colonization rate of Staphylococcus aureus strains among Health Care Service Employee’s of Teaching University Hospitals in Yazd. Acta Medica Iranica 2009; 47 (4): 315-317.

Mertz D, Frei R, Jaussi B, et al. Throat Swabs Are Necessary to Reliably Detect Carriers of Staphylococcus aureus. Clin Infect Dis 2007; 45 (4): 475-7.

Acton DS, Plat-Sinnige MJ, van Wamel W, et al. Intestinal carriage of Staphylococcus aureus: how does its frequency compare with that of nasal carriage and what is its clinical impact.Eur J Clin Microbiol Infect Dis 2009; 28 (2):115-27.

Wertheim HF, Melles DC, Vos MC, et al.The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis 2005; 5 (12): 751-62.

Kluytmans J, van Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 1997; 10: 505–520.

Chiang FY, Climo M. Staphylococcus aureus carriage and health care–acquired infection. Curr Infect Dis Rep 2002; 4:498–504.

Tong SY, Chen LF, Fowler VG Jr.Colonization, pathogenicity, host susceptibility, and therapeutics for Staphylococcus aureus: what is the clinical relevance. Semin Immuno pathol 2012; 34 (2):185-200.

Majumdar D, Ankur B, Barnali P. Nasal Carriage of Methicillin Resistant Staphylococci in Healthy Population of East Sikkim. Indian J Community Med 2009; 34 (4): 364-365.

Haley CC, Deepa M, Amanda V, et al. Methicillin-Resistant Staphylococcus aureus Infection or Colonization Present at Hospital Admission: Multivariable Risk Factor Screening To Increase Efficiency of Surveillance Culturing. J Clinic Microbiol.2007; 45 (9): 3031–3038.

Askarian M, Zeinalzadeh AH, Japoni A, et al. Prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus and its antibiotic susceptibility pattern in healthcare workers at Namazi Hospital, Shiraz, Iran. J Infec Dis 2009;13: e241-e247.

Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. 16th informational supplement M100-S16, CLSI, Wayne, PA, 2006.

Halablab MA, Hijazi SM, Fawzi MA, et al. Staphylococcus aureus nasal carriage rate and associated risk factors in individuals in the community. Epidemiol Infect 2010 May; 138 (5): 702-6.

Wertheim HF, Vos MC, Boelens HA, et al. Low prevalence of methicillin-resistant Staphylococcus aureus (MRSA) at hospital admission in the Netherlands: the value of search and destroy and restrictive antibiotic use. J Hosp Infect 2004; 56 (4):321-5.

Olsen K, Sangvik M, Simonsen GS, et al.Prevalence and population structure of Staphylococcus aureus nasal carriage in healthcare workers in a general population. The Tromsø Staph and Skin Study. Epidemiol Infect 2013; 141 (1):143-52.

Hidron AI, Kourbatova EV, Halvosa JS, et al. Risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to an urban hospital: emergence of community- associated MRSA nasal carriage. Clin Infect Dis 2005; 41 (2): 159-66.

Davis KA, Stewart JJ, Crouch HK, et al.Methicillin-Resistant Staphylococcus aureus (MRSA) Nares Colonization at Hospital Admission and Its Effect on Subsequent MRSA Infection. Clin Infect Dis 2004; 39 (15): 776-782.

Kenner J, O'Connor T, Piantanida N, et al.Rates of carriage of methicillin-resistant and methicillin-susceptible Staphylococcus aureus in an outpatient population. Infect Control HospEpidemiol 2003; 24 (6): 439-44.

Furuno JP, Perencevich EN, Johnson JA, et al. Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci co-colonization. Emerg Infect Dis 2005; 11(10): 1539-44.

Jernigan JA, Pullen AL, Flowers L, et al.Prevalence of and risk factors for colonization with methicillin-resistant Staphylococcus aureus at the time of hospital admission. Infect Control HospEpidemiol 2003;24(6):409-14.

Vinodhkumaradithyaa A, Uma A, Shirivasan M, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus among surgical unit staff. Jpn J Infect Dis 2009; 62 (3): 228-9.

Santos HB, Machado DP, Camey SA, et al. Prevalence and acquisition of MRSA amongst patients admitted to a tertiary- care hospital in Brazil. BMC Infect Dis 2010; 10: 328-334.

Pathak A, Marothi Y, Iyer RV, et al. Nasal carriage and antimicrobial susceptibility of Staphylococcus aureus in healthy preschool children in Ujjain, India. BMC Pediatr 2010; 10: 100.

Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. 24th informational supplement M100-S24, CLSI, Wayne, PA, 2014.

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SectionOriginal Articles
Keywords
Staphylococcus aureus Colonization Carrier Methicillin resistance

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How to Cite
1.
Naderi-Nasab M, Heydari AA, Booryazadeh V, Zarifian A, Meshkat Z, Afzalaghaei M. Investigating Colonization of Staphylococcus aureus among Patients Admitted to the Infectious Diseases Ward of Imam Hospital in Mashhad. J Med Bacteriol. 2015;3(3-4):32-39.