NASAL CARRIAGE OF STAPHYLOCOCCUS AUREUS WITH SPECIAL EMPHASIS ON METHICILLINRESISTANT STAPHYLOCOCCUS AUREUS AMONG STUDENTS OF A SOUTH INDIAN MEDICAL COLLEGE - PREVALENCE AND ANTIBIOGRAM PATTERN
Objective: There is paucity of information on carriage of Staphylococcus aureus and Methicillin Resistant S.aureus from developing nations including
the medical students who could be the potential transmitters. Present study was aimed at establishing the prevalence and antibiogram pattern of
S. aureus with special emphasis on MRSA among II year MBBS students of Kasturba Medical College, Mangalore.
Methods: A total of 148 students were participated in this study. Swabs taken from both anterior nares were processed, and the growth of S. aureus
was confirmed by standard procedure. Further categorization of S. aureus into MRSA was done using cefoxitin disc diffusion method, along with the
antibiogram to other common drugs.
Results: The number of strains of S. aureus isolated from our 148 participants was 78 with a percentage rate of 52.7. Of the 78 isolates of S. aureus,
9 (11.5%) were MRSA. The overall MRSA carriage rate was 6.1%.
Conclusion: The S. aureus and MRSA carriage rates recorded in this study were significantly higher when compared with other reported studies. It
was observed that risk factors like use of antibiotics in past 6 months and snoring were found to be statistically significant in nasal carriage status of
S. aureus. Out of nine MRSA carriers, six were found to be having the parents who were busy clinicians by occupation and the close contact with them
could be the prime factor in the acquisition of MRSA carriage status.
Keywords: Staphylococcus aureus, MRSA, Nasal carriage, Medical students.
1. Kluytmans JA, Wertheim HF. Nasal carriage of Staphylococcus aureus
and prevention of nosocomial infections. Infection 2005;33(1):3-8.
2. Peacock SJ, de Silva I, Lowy FD. What determines nasal carriage of
Staphylococcus aureus? Trends Microbiol 2001;9(12):605-10.
3. Lin YC, Lauderdale TL, Lin HM, Chen PC, Cheng MF, Hsieh KS, et al.
An outbreak of methicillin-resistant Staphylococcus aureus infection in
patients of a pediatric intensive care unitand high carriage rate among
health care workers. J Microbiol Immunol Infect 2007;40(4):325-34.
4. Deresinski S. Methicillin-resistant Staphylococcus aureus: An
evolutionary, epidemiologic, and therapeutic odyssey. Clin Infect Dis
5. Chambers HF. The changing epidemiology of Staphylococcus aureus?
Emerg Infect Dis 2001;7(2):178-82.
6. Naimi TS, LeDell KH, Como-Sabetti K, Borchardt SM, Boxrud DJ,
Etienne J, et al. Comparison of community- and health care-associated
methicillin-resistant Staphylococcus aureus infection. JAMA
7. Salgado CD, Farr BM, Calfee DP. Community-acquired methicillinresistant
Clin Infect Dis 2003;36(2):131-9.
8. Bischoff WE, Wallis ML, Tucker KB, Reboussin BA, Sherertz RJ.
Staphylococcus aureus nasal carriage in a student community:
Prevalence, clonal relationships, and risk factors. Infect Control Hosp
9. Eveillard M, Martin Y, Hidri N, Boussougant Y, Joly-Guillou ML.
Carriage of methicillin-resistant Staphylococcus aureus among hospital
employees: Prevalence, duration, and transmission to households.
Infect Control Hosp Epidemiol 2004;25(2):114-20.
10. Chambers HF. The changing epidemiology of Staphylococcus aureus?
Emerg Infect Dis 2001;7(2):178-82.
11. Albrich WC, Harbarth S. Health-care workers: Source, vector, or victim
of MRSA? Lancet Infect Dis 2008;8(5):289-301.
12. GÃ¼Ã§lÃ¼ E, Yavuz T, Tokmak A, BehÃ§et M, Karali E, OztÃ¼rk O, et al.
Nasal carriage of pathogenic bacteria in medical students: Effects of
clinic exposure on prevalence and antibiotic susceptibility. Eur Arch
13. Adesida SA, Abioye OA, Bamiro BS, Brai BI, Smith SI, Amisu KO,
et al. Associated risk factors and pulsed field gel electrophoresis of
nasal isolates of Staphylococcus aureus from medical students in a
tertiary hospital in Lagos, Nigeria. Braz J Infect Dis 2007;11(1):63-9.
14. Cheesbrough M. District Laboratory Practice in Tropical
Countries - Part 2. Cambridge: Cambridge University Press; 2008. p.
15. Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility
testing by a standardized single disk method. Am J Clin Pathol
16. CLSI. Surveillance for Methicillin-resistant Staphylococcus aureus:
Principles, Practices, and Challenges; A Report. CLSI Document
Radhakrishna et al.
Asian J Pharm Clin Res, Vol 9, Suppl. 2, 2016, 129-132
X07-R. Wayne, PA: Clinical and Laboratory Standards Institute; 2010.
17. Clinical and Laboratory Standards Institute. NCCLS Performance
Standards for Antimicrobial Disc Diffusion Tests; Approved Standards.
CLSI Document M2-M9. 9
ed. Wayne, PA: Clinical and Laboratory
Standards Institute; 2006.
18. Santhosh DV, Shobha KL, Bairy I, Rao G, Anand KM, Dâ€™Souza J.
Nasal screening and survey of pre-clinical medical students from
Malaysia for nasal carriage of coagulase positive MRSA and rate of
nasal colonization with Staphylococcus species. J Clin Diagn Res
19. Treesirichod A, Hantagool S, Prommalikit O. Nasal carriage and
antimicrobial susceptibility of Staphylococcus aureus among medical
students at the HRH Princess Maha Chakri Sirindhorn Medical
Center, Thailand: A cross sectional study. J Infect Public Health
20. Ma XX, Sun DD, Wang S, Wang ML, Li M, Shang H, et al. Nasal carriage
of methicillin-resistant Staphylococcus aureus among preclinical
medical students: Epidemiologic and molecular characteristics of
methicillin-resistant S. aureus clones. Diagn Microbiol Infect Dis
21. Shadi AZ. Prevalence of methicillin-resistant Staphylococcus aureus
nasal colonization among medical students in Jeddah, Saudi Arabia.
Saudi Med J 2015;36(7):807-12.
22. Sax H, Allegranzi B, UÃ§kay I, Larson E, Boyce J, Pittet D. â€˜My
five moments for hand hygieneâ€™: A user-centred design approach
to understand, train, monitor and report hand hygiene. J Hosp Infect
23. WHO. WHO Guidelines on Hand Hygiene in Health Care (Advanced
Draft): A Summary. Clean Hands are Safer Hands; 2005. Available
from: http://www.who.int/patientsafety/events/05/HH en.pdf. [Last
updated on 2005; Last cited on 2012 Apr 09].
24. Coia J, Duckworth G, Edwards DI, Farrington M, Fry C, Humphreys H,
et al. Guidelines for the control and prevention of methicillin-resistant
Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect
2006;63 Suppl 1:S1-44.
25. Doebbeling BN, Reagan DR, Pfaller MA, Houston AK, Hollis RJ,
Wenzel RP. Long-term efficacy of intranasal mupirocin ointment.
A prospective cohort study of Staphylococcus aureus carriage. Arch
Intern Med 1994;154(13):1505-8.
26. Kalmeijer MD, Coertjens H, van Nieuwland-Bollen PM, BogaersHofman
D, de Baere GA, Stuurman
of mupirocin nasal ointment in
Clin Infect Dis
27. Simor AE, Stuart TL, Louie L, Watt C, Ofner-Agostini M, Gravel D, et al.
Mupirocin-resistant, methicillin-resistant Staphylococcus aureus strains in
Canadian hospitals. Antimicrob Agents Chemother 2007;51(11):3880-6.
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