Methicillin-resistant S. aureus has been recognized as an important HAI pathogen worldwide because of the increased rate of multidrug resistance among the hospital acquired MRSA strains.
The present study shows 46% Staphylococcus aureus isolated from which 8.69% MRSA isolated from nasal cavity of HCWs of which 25% was resistant to mupirocin.Of the 3% CoNS, 33.33% were MRCoNS and showed no resistance to mupirocin.
The present study shows a prevalence of 8.69% for MRSA which is comparable to a study by Singh et al where the nasal carriage of MRSA among HCWs was found to be 7.5% [12]. Rongpharpi et al stated that Methicillin resistance was seen in 11.43% of the S.aureus isolates.[13]
A study by Kaur et al deduced that out of 140 nasal swabs collected from HCWs, S. aureus was isolated in 38 (27.14%), and CoNS was isolated in 73 (52.14%). MRSA was isolated in 20 (14.28%) and MRCoNS in 34 (24.29%).MSSA and MSCoNS isolates were 100% sensitive to mupirocin, but two isolates from MRSA (1.43%) and five from MRCoNS (3.57%) were mupirocin resistant.[8]
A study by Tiewsoh et al studied 432 samples, 24 (5.55%) were MRSA and 104 (24.07%) were MRCoNS. Only 4.16% (n = 1) showed high-level resistance to mupirocin among the MRSA isolates, while resistance among MRCoNS was higher at 6.7% (n = 7) for low-level resistance and 17.30% (n = 18) for high-level resistance.[1]
In a study by Shakya et al,MRSA prevalence rate was 10% among health-care personnel.[14]
In relation to the professional category, the lowest prevalence of colonization by the nursing staff (2.85%) followed by doctors (3.33%) and high prevalence was found in Housekeeping staff (5.71%) [Table II]. Agarwal et al reported 6% MRSA in nursing orderlies[15] .Tiewsoh et al reported 2.38% prevalence in Housekeeping Staff, 6.7% in Nurses and 2.38% in Doctors.[1]
Silva et al. observe that to develop activities like respiratory therapists or laboratory technicians represent a risk factor for the colonization by S. aureus. These individual possesses 4.57 times greater probability of being colonized when compared to doctors.[16]
The high prevalence of MRSA among housekeeping staff is probably due to the lack of knowledge and deficiency in information provided regarding infection control,use of PPE, proper hygiene while handling patients etc.
Mupirocin is the drug of choice for nasal carriers and has been effective for many years.By due to the injudicious use in recent times, resistnce has been noted to it.
In our study among the 100 HCW's, MSSA and MSCoNS isolates were 100% sensitive to mupirocin but one isolates from MRSA (25%) and zero from MRCoNS were mupirocin resistance, which is comparable to the findings of Kaur et al showing 1.43% mupirocin resistance in MRSA.[8]
Agarwal et al. reported 28 out of 200 HCWs showing nasal carriage of MRSA and mupirocin resistance was seen in four of them, of which three isolates were MupH and one was MupL [15].
Shakya et al. observed 0% resistance to mupirocin in the HCW's[14] whereas Tiewsoh et al noted 4.16% resistance.[1]