Abstract

NASAL METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS CARRIAGE IN PRE AND POST-OPERATIVE PATIENTS IN A TERTIARY HEALTH FACILITY IN UYO, SOUTH-SOUTH, NIGERIA

Moses A.E.*, Ohagim I.P. and Inyang U.C.

Abstract

Methicillin-resistant Staphylococcus aureus is responsible for a greater number of hospital acquired infections which are difficult to treat in humans. Infection increases when unsuspected patients with community-acquired strains are placed in situations that require longterm intensive nursing interventions and cross-infections spreading from patient to patient do occur. This study aimed to determine the nasal Methicillin-resistant Staph. aureus carriage in pre and postsurgical patients and also assess its multi-drug resistant pattern. Nasal swabs were collected from the anterior nares of patients on the same day of admission into the hospital wards, and 48-96 hours after surgery. Samples were analyzed using standard microbiological methods, while antimicrobial susceptibility testing was done using the improved Kirby-Bauer disc diffusion method. Staph. aureus isolates resistant to Cefoxitin and Oxacillin discs, were phenotypically regarded as Methicillin-resistant. Of the 130 samples, 26(40.0%) from pre-operative patients yielded Staph. aureus while additional 15(23.1%) from the erstwhile non-infected patients were detected after surgery. MRSA prevalence were 9.8% and 26.8% from pre-operative and post-operative patients, respectively. Four(15.4%) of the 26 pre-operative Staph. aureus isolates and 11(73.3%) of the 15 post-operative isolates were identified as MRSA. All the MRSA strains exhibited high resistance to Ciprofloxacin (80.0%), Trimethoprim/Sulphamethoxazole (73.3%), Tetracycline(66.7%), Erythromycin(66.7%) and Gentamycin(66.7%). Low resistance was observed with Vancomycin(6.7%) and Clindamycin(26.7%). All the MRSA strains exhibited multi-drug resistance in the combination of 4-8 antibiotics. The high rate of nasal MRSA colonization among pre-operative and post-operative patients signifies serious public health concern and emphasizes the need for a regular surveillance to forestall spread of multidrug resistance and nosocomial infections.

Keywords: Pre-and-post surgical patients, nasal colonization, MRSA strains.