NASAL CARRIAGE OF STAPHYLOCOCCUS AUREUS AND THE QUANTUM OF THEIR METHICILLIN RESISTANCE AMONGST THE HEALTH CARE WORKERS IN A PERIPHERAL TERTIARY CARE CENTRE OF EASTERN INDIA

OBJECTIVE: Stapylococcus aureus is an important pathogen causing hospital acquired infection in patients admitted to different clinical establishments. Amongst them MRSA is most important in causing morbidity, mortality and increase in economic burden not only to the patients but also to the society at large. Nasal carriage of the organism by the heath care workers always remains an important source of infection to the hospitalized patients and regular screening of colonized health care workers can prevent their transmission to the hospital and community. The present study was carried out in search of obtaining the actual level of nasal carriage in our set up and to arrange a corrective measure in this context. METHOD: A total of 183 nasal swabs were collected from different categories of staffs of Medinipur Medical College and Hospital, Paschim Medinipur, West Bengal from March 2014 to May 2014. Staph aureus isolates were identified by catalase test, coagulase test (Slide and tube) and mannitol fermentation. Methicillin resistance was detected by using cefoxitin disc 30microgram on Mueller Hinton agar with 4% sodium chloride. Vancomycin resistance was also detected by following CLSI guidelines. RESULTS: out of the 183 health care workers screened 39(21.7%) were identified as nasal carrier of Staphylococcus aureus of which 69.23% are nurses and doctors. Amongst the carriers 12(30.7%) are colonized by MRSA strains and 27(69.2%) by MSSA strains. Highest rate nasal colonization by MRSA (75%) were observed in nurses and doctors combined together. CONCLUSION: Nasal colonization of Staphylococcus aureus amongst Health care workers, particularly in the most educated group in our set up is quite high and what is more alarming is that 75% of them are MRSA carriers. They will be the potential source and vehicle of transmission to hospital set up and the community at large. Treatment should be given to them and awareness about hygienic methods are to be developed amongst all categories of HCW. Continuous surveillance will minimize the cost of treatment burden on to the patients and community.