Staphylococcal nasal carriage of health care workers.
OBJECTIVE
To determine the frequency of staphylococcal nasal carriage of health care workers (HCWs) and antimicrobial susceptibility profile of the isolates for appropriate decolonization therapy.


METHODS
An observational study.


METHODS
The study was conducted at Holy Family Hospital, Rawalpindi, during the period from May 2007 to April 2008.


METHODS
Nasal swabs from anterior nares of HCWs were cultured and identified as Staphylococcus aureus, coagulasenegative staphylococci (CoNS), methicillin-resistant S. aureus (MRSA), methicillin-resistant CoNS (MRCoNS) by using standard methods. Antimicrobial susceptibility testing was performed on Muller Hinton Agar using disc diffusion method.


RESULTS
Of the 468 HCWs, 213 (45.5%) participants were men and 255 (54.5%) were women. Eighty five (18.2%) were nasal carriers of S. aureus, 07 (1.5%) for MRSA, 343 (73.3%) for CoNS and 10 (2.1%) for MRCoNS. The highest carriage rate for S. aureus was in midwives (30%) followed by maintenance staff (28.6%), security guards (25%), technicians (23.5%), staff nurses (22.7%) and < 20% in house physicians and nursing students. Carriage rate in HCWs from different departments was: surgical ICU (40%), gynaecology (34.9%), delivery room (30%), gynaecology operation rooms (25%), medicine (22.7%) and < 20% in pediatrics and surgery. All isolates were susceptible to vancomycin, imipenem and levofloxacin and > 90% of S. aureus and CoNS were susceptible to amikacin, gentamicin and fluoroquinolones tested.


CONCLUSIONS
Fluoroquinolones, preferably oral levofloxacin in combination with topical gentamicin ointment, in places like Pakistan where mupirocin is not routinely available, can be used for decolonization of nasal staphylococcal carriage.
Akhtar
Naeem
N
Department of Pathology, Rawalpindi Medical College, Rawalpindi, Pakistan. naeeakh@yahoo.com
D000328:Adult; D002353:Carrier State; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D009666:Nose / Q000382:microbiology*; D010154:Pakistan; D010564:Personnel, Hospital; D013210:Staphylococcus / Q000302:isolation & purification*; D013211:Staphylococcus aureus / Q000302:isolation & purification*