Abstract

Background: Infections caused by multidrug-resistant organisms (MDROs) have been increasingly reported from healthcare facilities. The spread of MDROs in hospitals further increases the financial burden on healthcare facility due to prolonged hospital stays and the need for more expensive investigations and treatment. Methicillin Resistant Staphylococcus aureus (MRSA) is known to be widely distributed in the healthcare facilities and accounts for a substantial proportion of the infectious disease burden. Hence, active surveillance for MRSA is carried out to identify colonized patients or Healthcare workers (HCWs) in a facility. This prospective study was conducted to study and compare the carriage of MRSA among doctors, nurses, General Duty Attendants (GDA) and Houseman/ House woman (HM/HW) working in cardiac unit of a tertiary care hospital. Screening was done by collecting swabs from hands and anterior nares. These specimens were processed by standard procedures for the isolation of Staphylococcus aureus and resistance to methicillin was determined using cefoxitin, 30µg disks as per Clinical and Laboratory Standards Institute (CLSI) guidelines. The carriage rate of MRSA was found to be highest among HM/HW (13%) followed by nurses (8%) and GDA (7%). Out of 11 doctors screened, none was found to carry MRSA. A higher percentage carriage in HM/HW can probably be accounted to their close and prolonged contact with infected patients and involvement in activities like emptying urinary bags, floor mopping and other activities of environmental cleaning. Management of MRSA carriers include applying stringent hand hygiene, contact precautions and core strategies including isolating and cohorting patients, increased environmental cleaning, dedicated patient equipment and decolonization. Active surveillance including screening of HCWs can help in decreased risk of spread to their close contacts and further reduction of MRSA prevalence among patients.

Description