Evaluation of Staphylococcus aureus Presence and Meticillin Resistance in Nasal Swab Samples in Erzincan Mengucek Gazi Training and Research Hospital

Abstract

Objective: To investigate the Staphylococcus aureus strains and methicillin resistance rates retrospectively isolated from nose swab samples sent from various clinics to our laboratory during the study period. Materials Method: 3002 nose swab samples were sent to Erzincan Mengücek Gazi Training and Research Hospital Microbiology Laboratory between January 2015 and January 2020. Samples were inoculated in 5% sheep blood and chromogenic MRSA medium. The media were incubated at 35 oC for 24 hours. Colonies compatible with S.aureus in 5% sheep blood medium and forming pink color in MRSA medium were evaluated. Methicillin susceptibilities of isolates identified as S.aureus by conventional methods and subsequently by MALDI - TOF MS system were determined by Kirby-Bauer disc diffusion method in Mueller Hinton agar. Sensitivity results were interpreted according to EUCAST guidelines. Results: S.aureus was isolated in 536 (17.8%) of the samples. 491 (91.6 %) of the patients with reproduction were male and 45 (8.4%) were female. 504 (94 %) of the 536 isolated S.aureus strains were found to be methicillin-sensitive S.aureus (MSSA) and 32 (6 %) were methicillin-resistant S.aureus (MRSA). 31 of the MRSA isolated patients were male and the mean age was 26.3. The lowest number of MRSA cases was determined in 2015 and the highest in 2019. All MRSA isolates were isolated from outpatients. Conclusion: In our study, the nasal S.aureus carrier rate was 17.8 %, and nasal MRSA carrier rate was 6%. Investigation of the nasal presence of S. aureus, an important pathogen for hospital and community-acquired infections, and determination of antibiotic sensitivity will be effective in preventing these infections. Especially for the prevention and control of MRSA transmission; It is necessary to reduce uncontrolled and excessive use of antibiotics, to comply with hand hygiene rules, to screen the carriers periodically and to pay attention to contact measures

Keywords

• staphylococcus aureus
• methicillin resistance
• nasal swab
• infection control

References

1. 1. Artan C, Artan MO ve Baykan Z. Hastane çalışanlarında Staphylococcus aureus nazal taşıyıcılığı ve indüklenebilir klindamisin direnci. Düzce Üni Sağ Bil Enst Derg 2013; 3(2): 1-4.
2. 2. Cesur S, Yıldız E, H I, Aygün Z ve ark. Staphylococcus aureus klinik izolatlarında metisilin direncinin saptanmasında oksasilin direnci tarama agar ve kromojenik MRSA agar besiyerlerinin değerlendirilmesi. Mikrobiyol Bul 2010; 44: 279-284.
3. 3. Şamlıoğlu P, Bayram A, Hancı S, Ağuş N ve ark. İzmir Tepecik Eğitim ve Araştırma Hastanesi’nde Nazal Sürüntü Örneklerinde Metisilin Duyarlı ve Metisilin Dirençli Staphylococcus aureus Değerlendirilmesi. Türk Mikrobiyol Cem Derg 2018; 48(2): 130-133.
4. 4. Arıdoğan A, Atasever L ve Bal Ç. Klinik örneklerden izole edilen Staphylococcus aureus suşlarının antibiyotiklere dirençleri. Turk Mikrobiyol Cem Derg 2004; 34: 20-23.
5. 5. Topçu AW, Söyletir G ve Doğanay M (Editörler). İnfeksiyon Hastalıkları ve Mikrobiyolojisi.Nobel Tıp Kitabevleri 2020: İstanbul; 1500-1510.
6. 6. Çiftçi A, Erol Ö, Kaya C, Ergen E ve ark. Hemodiyaliz Hastalarında MRSA Burun Taşıyıcılığı ve VRE Rektal Taşıyıcılığı Oranlarının Belirlenmesi. Ortadogu Tıp Derg 2013; 5(4): 214-218.
7. 7. EUCAST. Breakpoints tables for interpretation of MICs and zone diameters. EUCAST documents version 8.0. European Committee on Antimicrobial Susceptibility Testing, 2018.
8. 8. Alim A, Artan MO, Ataş M, KAlkan H ve ark. Nasal carriage rate of Staphylococcus aureus in individuals participating in the routine carrier inspection process in Sivas. Flora 2012; 7(4): 202-205.

9. 9. Ören MM, Evciman A ve Duman A. Bir tıp fakültesi hastanesinde gıda çalışanlarının periyodik sağlık taramalarının değerlendirilmesi. İst Tıp Fak Derg 2014; 77(4): 51-54.
10. 10. Vos A ve Doebbeling BN. The world-wide prevalence of methicillin-resistant Staphylococcus aureus. Int J Antimicrob Agents 1995; 5: 101-106.
11. 11. Çoban AY, Demirpek U, Çiftçi A ve Bozdoğan B. Staphylococcus aureus metisilin direncinin hızlı saptanmasında nitrat redüktaz testi: Bir sınır değer duyarlılık test yöntemi. Mikrobiyol Bul 2014; 48(1): 40-47.
12. 12. Yağmur G ve İnci M. Investigation of Nasal Carriage and Antibiotic Susceptibility of Staphylococcus aureus in Healthcare Staff. Harran Üni Tıp Fak Derg 2015; 12(1): 31-37.
13. 13. Köseoğlu Ö, Kutlu SS ve Cevahir N. Ayaktan hemodiyaliz tedavisi alan hastalarda nazal metisiline dirençli Staphylococcus aureus kolonizasyon prevalansı ve risk faktörleri. Mikrobiyol Bul 2012; 46(1): 106-112.
14. 14. Özen NS, Ataman ŞT, Seyman D, Aldağ H ve ark. Antalya ili gıda çalışanlarında nazal Staphylococcus aureus taşıyıcılığının ve MRSA oranlarının üç farklı yöntem kullanılarak incelenmesi. Turk Hij Den Biyol Derg 2013; 70(2): 51-55.
15. 15. Arca EA, Karabiber N ve Şen S. Preoperatif burun kültürlerinde Staphylococcus aureus araştırılması. Türk Hij Den Biyol Derg 2007; 64(3): 23-26.
16. 16. Reta A, Wubie M ve Mekuria G. Nasal colonization and antimicrobial susceptibility pattern of Staphylococcus aureus among pre-school children in Ethiopia. BMC Res Notes 2017; 10(1): 746.
17. 17. Heckel M, Geißdörfer W, Herbst FA, Stiel S, ve ark. Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) at a palliative care unit: A prospective single service analysis. PLoS One 2017; 12(12): 1-14.
18. 18. Çifci A, Biberoğlu S, Tosun İ, Cesur S, Gençtürk Z ve ark. The rate and risk factors of nasal Staphylococcus aureus carriage in hemodialysis patients. Turk J Clin Lab 2016: 7(4): 94-98.
19. 19. Karapınar B, Yılmaz M, Ömeroğlu M, Erbudak E, Köse A ve ark. Pyodermisi Olan Hastalarda Toplum Kökenli Metisiline Dirençli Staphylococcus aureus Sıklığının ve Burun Taşıyıcılığının Belirlenmesi. Klimik Derg 2018; 31(2): 115-119.