ECZACI VE ECZANE PERSONELİNDE STAPHYLOCOCCUS AUREUS BURUN TAŞIYICILIĞI

Year 2023, , 277 - 283, 20.01.2023

Halil Bal , Sulhiye Yıldız

https://doi.org/10.33483/jfpau.1211002

Abstract

Amaç: Bu çalışmanın amacı eczacı ve eczane personelindeki Staphylococcus aureus (S. aureus) burun taşıyıcılık oranlarının ve risk faktörlerinin belirlenmesidir.

Gereç ve Yöntem: Ankara’daki eczanelerde çalışan eczacı ve eczane personelinden oluşan gönüllü bireylerden 300 nazal sürüntü örneği toplandı. Örnekler fenotipik yöntemler ile S. aureus olarak tanımlandı. Suşların metisilin direnci CLSI önerileri doğrultusunda disk difüzyon yöntemi ile belirlendi ve mecA geninin varlığı polimeraz zincir reaksiyonu (PZR) ile araştırıldı. Gönüllülerden bazı sorulara (yaş, cinsiyet vb.) cevap vermesi istenerek nazal S. aureus taşıyıcılığı için risk faktörleri araştırıldı.

Sonuç ve Tartışma: 300 örneğin 64’ü (21.3%) S. aureus ve 4’ü (1.3%) metisilin dirençli Staphylococcus aureus (MRSA) olarak tespit edildi. Nazal S. aureus taşıyıcılık oranları eczacılarda % 25.7, eczane personelinde % 20 olarak belirlendi. Bu iki grup arasında anlamlı bir fark bulunmadı (p>0.05). Bazı risk faktörleri (sigara içmek, şeker hastası olmak ve son bir yıl içerisinde hastanede ayakta tedavi görmek) ile nazal S. aureus taşıyıcılığı arasında anlamlı bir fark bulundu (p<0.05). El hijyenine ve enfeksiyon kontrol politikalarına uyumun S. aureus ve MRSA taşıyıcılık oranlarını azaltabileceğini düşünmekteyiz.

Keywords

mecA, methicillin resistance Staphylococcus aureus, polymerase chain reaction, Staphylococcus aureus

Supporting Institution

Sivas Cumhuriyet Üniversitesi Bilimsel Araştırma Projeleri Birimi

Project Number

ECZ-010

Thanks

Bu çalışmaya desteklerinden dolayı Sivas Cumhuriyet Üniversitesine, Sivas Cumhuriyet Üniversitesi Araştırma Projeleri Birimine, çalışmamıza katılan gönüllü bireylere teşekkür ederiz.

NASAL CARRIAGE OF STAPHYLOCOCCUS AUREUS IN PHARMACIST AND PHARMACY PERSONNEL

Abstract

Objective: The aim of this study was to determine the Staphylococcus aureus (S. aureus) nasal carriage rates and risk factors in pharmacist and pharmacy personnel.

Material and Method: 300 nasal swabs were collected from volunteers (pharmacist and pharmacy personnel) working in pharmacies in Ankara, Turkey. Samples were identified as S. aureus by phenotypic methods. Methicillin resistance of the strains was determined in accordance with the recommendations of the Clinical and Laboratory Standards Institute (CLSI) by the disk diffusion method and the presence of the mecA gene was investigated by Polymerase Chain Reaction (PCR). Volunteers were asked to answer some questions (age, sex etc.) and risk factors for nasal S. aureus carriage were investigated.

Result and Discussion: S. aureus was detected in 64 (21.3%) of 300 samples and of which 4 (1.3%) were identified as Methicillin Resistance Staphylococcus aureus (MRSA). S. aureus carriage rates were found to be 25.7% in pharmacist and 20% in pharmacy personnel. There was no significant difference between these two groups (p>0.05). A significant difference was found between some risk factors (smoking, diabetes, and outpatient treatment in hospital within the past year) and nasal S. aureus carriage (p<0.05). We think that compliance with hand hygiene and effective infection control policies can reduce the rates of S. aureus and MRSA carriage.

Keywords

mecA, methicillin resistance Staphylococcus aureus, polymerase chain reaction, Staphylococcus aureus

Project Number

ECZ-010

References

• 1. Boisset, S., Saadatian-Elahi, M., Landelle, C., Bes, M., Gustave, C.A., Tristan, A., Fassier, J.B., Laurent, F., Grando, J., Vandenesch, F., Bouchiat, C. (2019). Unexpected categories at risk of S. aureus nasal carriage among hospital workers. International Journal of Hygiene and Environmental Health, 222(8), 1093-1097. [CrossRef]
• 2. Emaneini, M., Jabalameli, F., Rahdar, H., Leeuwen, W., Beigverdi, R. (2017). Nasal carriage rate of methicillin resistant Staphylococcus aureus among Iranian healthcare workers: A systematic review and meta-analysis. Revista da Sociedade Brasileira de Medicina Tropical, 50(5), 590-597. [CrossRef]
• 3. Kwiecinski, J.M., Horswill, A.R. (2020). Staphylococcus aureus bloodstream infections: Pathogenesis and regulatory mechanisms. Current Opinion in Microbiology, 53, 51-60. [CrossRef]
• 4. Wertheim, H.F., Vos, M.C., Ott, A., van Belkum, A., Voss, A., Kluytmans, J.A., van Keulen, P.H., Vandenbroucke-Grauls, C.M., Meester, M.H., Verbrugh, H.A. (2004). Risk and outcome of nosocomial Staphylococcus aureus bacteraemia in nasal carriers versus non-carriers. The Lancet, 364(9435), 703-705. [CrossRef]
• 5. Wertheim, H.F., Melles, D.C., Vos, M.C., van Leeuwen, W., van Belkum, A., Verbrugh, H.A., Nouwen, J.L. (2005). The role of nasal carriage in Staphylococcus aureus infections. The Lancet Infectious Diseases, 5(12), 751-762. [CrossRef]
• 6. Gul M, Çıragil P, Aral M. (2004). Staphylococcus aureus nasal and hand carriage in hospital staff of medical faculty of Kahramanmaras Sutcu Imam University. Antibiyotik ve Kemoterapi Derneği Dergisi, 18, 36-39.
• 7. Albrich, W.C., Harbarth, S. (2008). Health-care workers: Source, vector, or victim of MRSA? The Lancet Infectious Diseases, 8(5), 289-301. [CrossRef]
• 8. Chen, K.H., Chuang, W.C., Wong, W.K., Chuang, C.H., Chen, C.J., Huang, Y.C. (2020). Nasal methicillin-resistant Staphylococcus aureus carriage among foreign workers recruited to Taiwan from southeastern asian countries. Open Forum Infectious Diseases, 8(1), ofaa586. [CrossRef]
• 9. Vazquez-Guillamet, C., Kollef, M.H. (2014). Treatment of gram-positive infections in critically ill patients. Boston Medical Center infectious diseases, (14), 92. [CrossRef]
• 10. Boyce, J.M., Pittet, D. (2002). Healthcare Infection Control Practices Advisory Committee, HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infection Control & Hospital Epidemiology, 23(S12), S3-S40. [CrossRef]
• 11. Cirkovic, I., Stepanovic, S., Skov, R., Trajkovic, J., Grgurevic, A., Larsen, A.R. (2015). Carriage and genetic diversity of methicillin-resistant Staphylococcus aureus among patients and healthcare workers in a serbian university hospital. PloS One, 10(5), e0127347. [CrossRef]
• 12. Akhtar N. (2010). Staphylococcal nasal carriage of health care workers. Journal of the College of Physicians and Surgeons Pakistan, 20(7), 439-443.
• 13. Calfee, D.P., Salgado, C.D., Classen, D., Arias, K.M., Podgorny, K., Anderson, D.J., Burstin, H., Coffin, S.E., Dubberke, E.R., Fraser, V., Gerding, D.N., Griffin, F.A., Gross, P., Kaye, K.S., Klompas, M., Lo, E., Marschall, J., Mermel, L.A., Nicolle, L., Pegues, D.A., Yokoe, D.S. (2008). Strategies to prevent transmission of methicillin-resistant Staphylococcus aureus in acute care hospitals. Infection Control and Hospital Epidemiology, 29 Suppl (1), S62-S80. [CrossRef]
• 14. Kloos W, Lambe D. (1991). Staphylococcus. In: A. Barlows, W.J. Hausler, K.L. Herrmann, H.D. Isenberg, H.J. Shadomy (Eds.), Manual of Clinical Microbiology, (pp. 222-237) 5th ed. Washington D.C.: American Society for Microbiology.
• 15. CLSI. (2012). Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard-9th ed., CLSI document M07-A9. Clinical and Laboratory Standards Institute, Pennsylvania, USA.
• 16. Okamoto, R., Okubo, T., Inoue, M. (1996). Detection of genes regulating beta-lactamase production in Enterococcus faecalis and Staphylococcus aureus. Antimicrobial Agents and Chemotherapy, 40(11), 2550-2554. [CrossRef]
• 17. Araj, G.F., Talhouk, R.S., Simaan, C.J., Maasad, M.J. (1999). Discrepancies between mecA pcr and conventional tests used for detection of methicillin resistant Staphylococcus aureus. International Journal of Antimicrobial Agents, 11, 47-52. [CrossRef]
• 18. Price, J.R., Cole, K., Bexley, A., Kostiou, V., Eyre, D.W., Golubchik, T., Wilson, D.J., Crook, D.W., Walker, A.S., Peto, T., Llewelyn, M.J., Paul, J. (2017). Modernising Medical Microbiology informatics group Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing. The Lancet Infectious Diseases, 17(2), 207-214. [CrossRef]
• 19. Rashid, Z., Farzana, K., Sattar, A., Murtaza, G. (2012). Prevalence of nasal Staphylococcus aureus and methicillin-resistant Staphylococcus aureus in hospital personnel and associated risk factors. Acta Poloniae Pharmaceutica, 69(5), 985-991.
• 20. Garcia, C., Acuna-Villaorduna, A., Dulanto, A., Vandendriessche, S., Hallin, M., Jacobs, J., Denis, O. (2016). Dynamics of nasal carriage of methicillin-resistant Staphylococcus aureus among healthcare workers in a tertiary-care hospital in Peru. European Journal of Clinical Microbiology & Infectious Diseases, 35(1), 89-93. [CrossRef]
• 21. Genc, O., Arikan, I. (2020). The relationship between hand hygiene practices and nasal Staphylococcus aureus carriage in healthcare workers. La Medicina del Lavoro, 111(1), 54-62. [CrossRef]
• 22. Hefzy, E.M., Hassan, G.M., Abd El Reheem, F. (2016). Detection of panton-valentine leukocidin-positive methicillin-resistant Staphylococcus aureus nasal carriage among Egyptian health care workers. Surgical Infections, 17(3), 369-375. [CrossRef]
• 23. Chen, B., Dai, X., He, B., Pan, K., Li, H., Liu, X. (2015). Differences in Staphylococcus aureus nasal carriage and molecular characteristics among community residents and healthcare workers at Sun Yat-Sen University, Guangzhou, Southern China. Boston Medical Center Infectious Diseases, 15, 303. [CrossRef]
• 24. de Benito, S., Alou, L., Becerro-de-Bengoa-Vallejo, R., Losa-Iglesias, M.E., Gomez-Lus, M.L., Collado, L., Sevillano, D. (2018). Prevalence of Staphylococcus spp. nasal colonization among doctors of podiatric medicine and associated risk factors in Spain. Antimicrobial Resistance and Infection Control, 7, 24. [CrossRef]
• 25. Kampf, G., Adena, S., Rüden, H., Weist, K. (2003). Inducibility and potential role of mecA-gene-positive oxacillin-susceptible Staphylococcus aureus from colonized healthcare workers as a source for nosocomial infections. The Journal of Hospital Infection, 54(2), 124-129. [CrossRef]
• 26. Ibarra, M., Flatt, T., Van Maele, D., Ahmed, A., Fergie, J., Purcell, K. (2008). Prevalence of methicillin-resistant Staphylococcus aureus nasal carriage in healthcare workers. The Pediatric Infectious Disease Journal, 27(12), 1109-1111. [CrossRef]
• 27. Buenaventura-Alcazaren, F.A., Dela Tonga, A., Ong-Lim, A., Destura, R.V. (2020). Prevalence and molecular characteristics of MRSA nasal carriage among hospital care workers in a tertiary hospital in the Philippines. Journal of Microbiology, Immunology and Infection, 53(5), 739-745. [CrossRef]
• 28. Alp, E., Damani, N. (2015). Healthcare-associated infections in intensive care units: Epidemiology and infection control in low-to-middle income countries. Journal of Infection in Developing Countries, 9(10), 1040-1045. [CrossRef]
• 29. McEachern, E.K., Hwang, J.H., Sladewski, K.M., Nicatia, S., Dewitz, C., Mathew, D.P., Nizet, V., Crotty Alexander, L.E. (2015). Analysis of the effects of cigarette smoke on staphylococcal virulence phenotypes. Infection and Immunity, 83(6), 2443-2452. [CrossRef]
• 30. Giri, N., Maharjan, S., Thapa, T.B., Pokhrel, S., Joshi, G., Shrestha, O., Shrestha, N., Rijal, B.P. (2021). Nasal carriage of methicillin-resistant Staphylococcus aureus among healthcare workers in a tertiary care hospital, Kathmandu, Nepal. International Journal of Microbiology, 8825746. [CrossRef]
• 31. Anafo, R.B., Atiase, Y., Kotey, F., Dayie, N., Tetteh-Quarcoo, P.B., Duodu, S., Osei, M.M., Alzahrani, K.J., Donkor, E.S. (2021). Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage among patients with diabetes at the Korle Bu Teaching Hospital. PloS One, 16(9), e0257004. [CrossRef]
• 32. Huifen Y, Junshao Z, Wenzhou Q (2015). Study on colonization status and risk factors of methicillin resistant Staphylococcus aureus in patients of intense care units. Chinese Journal of Disinfection, 32, 24-26. 33. Chen, C.C., Pass, S.E. (2013). Risk factors for and impact of methicillin-resistant Staphylococcus aureus nasal colonization in patients in a medical intensive care unit. American Journal of Infection Control, 41(11), 1100-1101. [CrossRef]
• 34. Stenstrom, R., Grafstein, E., Romney, M., Fahimi, J., Harris, D., Hunte, G., Innes, G., Christenson, J. (2009). Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department. Canadian journal of Emergency Medical Care, 11(5), 430-438. [CrosssRef]
• 35. Ahluwalia, A., Sood, A., Sood, A., Lakshmy, R., Kapil, A., Pandey, R.M. (2000). Nasal colonization with Staphylococcus aureus in patients with diabetes mellitus. Diabetic Medicine: A Journal of the British Diabetic Association, 17(6), 487-488.
• 36. Hart, J., Hamilton, E.J., Makepeace, A., Davis, W.A., Latkovic, E., Lim, E.M., Dyer, J.R., Davis, T.M. (2015). Prevalence, risk factors and sequelae of Staphylococcus aureus carriage in diabetes: The Fremantle Diabetes Study Phase II. Journal of Diabetes and Its Complications, 29(8), 1092-1097. [CrossRef]