Prevalence of Methicillin-resistant Staphylococcus aureus among Health Care Workers in Tripoli Hospital, Libya

Abstract

Aims: Staphylococcus aureus is a common cause of community and a hospital infection, methicillin-resistant Staphylococcus aureus (MRSA), is a common nosocomial infection pathogen, its resistance to multiple antibiotics has made it difficult to control. Healthcare workers are the most important source of MRSA nosocomial transmission in hospital. The main aim of our study is to determine the prevalence of MRSA, which was isolated from healthcare workers nasal carriage from different department of Tripoli center Hospital in Libya, as well as to determine the resistance of the MRSA isolates to commonly used antibiotics. Study Design: This cross sectional study was carried out at central medical center of Tripoli. Informed healthcare workers from different department of Tripoli center Hospital in Libya participated in this study. The Nasal swabs samples of Health care workers were collected for microbiology screening for MRSA. Place and Duration of Study: Samples were collected from Health care workers present in the different departments of Tripoli Centre hospitals from January– July 2013. Methodology: A total of 408 nasal swabs of health care works in center Tripoli hospital were collected and microbiology laboratory investigation for positive results, which were identified as S. aureus that were mannitol fermenting colonies, gram-positive cocci, catalase positive and coagulase positive. The disc diffusion methods were used for antibiotic susceptibility test and methicillin resistance. Results: The 408 nasal swabs samples were collected from healthcare workers out of which 64 (15.7%) isolated S. aureus and 14 (21.9%) MRSA. The highest MRSA rate was in samples collected from nurses (7.8%). About the department, the surgical wards and operating room had the highest rate of MRSA (28.6%) than other hospital department that participated in this study. The MRSA isolated from Health care workers were tested for antibiotic resistance, the result was erythromycin (75%), ciprofloxacin (70%), clindamycin (30%), trimethoprim/sulfamethoxazole (50%), quinuprisin/dalfopristin (20%), vancomycin (15%) and mupirocin (4%). The disk diffusion result indicated that 20% of those isolates had inducible resistance to clindamycin (MLSBi) and about 11% were characterized as having an MLSBc (constitutive) phenotype. Conclusion: The results provide evidence that Libyan health care workers could serve as MRSA carriers and play a role in the dissemination of MRSA to the public and other workers.