Effectiveness of simple control measures on methicillin-resistant Staphylococcus aureus infection status and characteristics with susceptibility patterns in a teaching hospital in Peshawar.
OBJECTIVE
To determine the effectiveness of simple control measures on the infection status and characteristics of methicillin-resistant Staphylococcus aureus including susceptibility patterns among health professionals and patients in a teaching hospital.


METHODS
The cross-sectional study was conducted from September 2013 to January 2014, and comprised samples collected from healthcare personnel and patients in the various units of Khyber Teaching Hospital, Peshawar. The specimens were collected before and one month after the implementation of simple control measures for outbreak prevention of methicillin-resistant Staphylococcus aureus. These were tested for culture and antimicrobial susceptibility. Data about methicillin-sensitive and methicillin-resistant Staphylococcus aureus infection, wound characteristics and susceptibility patterns was collected and effectiveness of simple control measures was determined. SPSS 20 was used for statistical analysis.


RESULTS
Of the total 390 isolates, 180(46.2%) were Staphylococcus aureus; 77(19.7%) from healthcare personnel and 103(26.4%) from patients. Of these, 164(42.1%) were methicillin-sensitive and 16(4.1%) were methicillin-resistant. Among the patients, 38(15.1%) methicillin-sensitive and 8(3.2%) methicillin-resistant isolates were recovered from wounds or skin and soft tissues. Pus with 33(13.1%) and 4(1.6%) cases respectively was the second most common source. Among methicillin-resistant isolates, resistance to Linezolid was 0%, all were resistant to Oxacillin, Cefoxitin, Amoxicillin, Cefotaxime and Cephradine, and resistance to both Co-Amoxiclav and Ciprofloxacin was 87.5%. After one month of implementation of simple control measures, the number of methicillin-resistant cases among healthcare professionals and patients dropped from 4(2.9%) and 7(10.8%) to 1(0.7%) and 5(2.7%), respectively.


CONCLUSIONS
Methicillin-resistant and methicillin-sensitive Staphylococcus aureus differed in their anti-microbial susceptibility profiles. Selection of antibiotics based on susceptibility and culture is needed for prevention of resistance and effective treatment. A decrease was observed in methicillin-resistant cases with implementation of control measures.
Surgical D Unit, Khyber Teaching Hospital, Peshawar, Pakistan.
Muhammad Salman
MS
Rafiq
Medical B Unit, Lady Reading Hospital, Peshawar, Pakistan.
Muhammad Imran
MI
Rafiq
Surgical D Unit, Khyber Teaching Hospital, Peshawar, Pakistan.
Taimur
T
Khan
Gynae B Unit, Hayatabad Medical Complex, Peshawar, Pakistan.
Maria
M
Rafiq
Surgical D Unit, Khyber Teaching Hospital, Peshawar, Pakistan.
Mah Muneer
MM
Khan
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D004198:Disease Susceptibility; D024881:Drug Resistance, Bacterial; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents
Staphylococcus aureus, Methicillin resistant, Susceptible, Hospital, Acquired infections.