PREVALENCE OF METHICILLIN-SENSITIVE STAPHYLOCOCCUS AUREUS ISOLATED FROM THE NOSTRILS OF STUDENTS OF MICHAEL OKPARA UNIVERSITYOF AGRICULTURE, UMUDIKE

ABSTRACT

The prevalence of methicillin sensitive Staphylococcus aureus in Michael Okpara University of Agriculture, Umudike, Abia state was investigated. Out of 85 samples cultured 80 isolates of Staphylococcus aureus were identified which were made up of 45 males, and 35 females. The antibiotic susceptibility test was done using Agar disk diffusion method. Multiple disk containing 8 antibiotics, Cloxacillin, Ofloxacin, Erythromycin, Gentamicin, Ceftazidine, Cefuroxime, Augmentin, and Ceftriazone was used. There was moderately high sensitivity of the Staphylococcus aureus isolates to Cloxacillin which had 38 (47.5%) which was represented as methicillin. Staphylococcus aureus that was also sensitive to other antibiotics; Ofloxacin 21 (26.25%), Ceftazidine 25 (31.25%), Ceftriazone 5 (6.25%), Cefuroxime 22 (27.5%), Gentamicin 21 (26.25%), Augmentin 23 (28.75%), and Erythromycin 6 (7.5%). From this study, with the percentage susceptibility of Cloxacillin being 38 (47.5%), it can be said that there is a moderate prevalence of methicillin sensitive among students of Michael Okpara University of Agriculture, Umudike in Abia State.

TABLE OF CONTENTS

Title Page                                                                                                                                                                    i

Certification                                                                                                                                                               ii

Dedication                                                                                                                                                                  iii

Acknowledgement                                                                                                                                                      iv

Table of Contents                                                                                                                                                       v

List of Tables                                                                                                                                                              vii

Abstract                                                                                                                                                                      viii

CHAPTER ONE

1.0           Introduction                                                                                                                1

1.1       Aims and objectives                                                                                                   3

CHAPTER TWO

2.0       Literature Review                                                                                                                                                       4

2.1       The Organism Staphylococcus aureus                                                                       5

2.2       General Characteristics                                                                                              5

2.3       Pathogenicity/Toxicity                                                                                               5

2.4       Mode of Transmission                                                                                                6

2.5       Mode of Reproduction                                                                                               7

2.6       Virulence factors                                                                                                        7

2.7       Role of Staphylococcus aureus in causing disease                                                    9

2.8       Antibiotic resistance and sensitivity                                                                           10       

2.9       Methicillin Sensitive Staphylococcus aureus (MSSA)                                              10

2.10     Prevention and Control of MSSA                                                                               11

CHAPTER THREE

3.0       Materials and Method                                                                                                 13

3.1       Study Area                                                                                                                  13       

3.2       Study Design                                                                                                              13

3.3       Sample Collection                                                                                                      13

3.4       Sterilization of Materials                                                                                            13

3.5       Preparation of Culture Media                                                                                     13

3.6       Isolation and Identification of Staphylococcus aureus                                               14

3.7       Gram Staining                                                                                                            14

3.8       Biochemical Tests                                                                                                      15

3.9       Preparation of Turbidity Standard Equivalent to

Mc Farland Standard (0.5)                                                                                          16

3.10     Antibiotic Susceptibility Test                                                                                     16

3.11     Measurement of Zone Of Inhibition                                                                           16                                           

CHAPTER FOUR

4.0       Results                                                                                                                        17

CHAPTER FIVE

5.1       Discussion                                                                                                                   23

5.2       Conclusion                                                                                                                  24

5.3       recommendation                                                                                                         24

References

LIST OF TABLES

1:           Identification and Characterization of S. aureus Isolates                                           18       

2:         Occurance of S. aureus in nostril passage of student

of Michael Okpara University of Agriculture, Umudike                                           19

3:         Antimicrobial Susceptibility Profile of

Staphylococcus aureus isolates (pattern of inhibition)                                              20

4:         Antimicrobial susceptibility profile of S. aureus      

isolated from nostril of students of Michael Okpara University                                    21

5:         Percentage of Isolates Sensitive to Methicillin (Cloxacillin)                                     22

CHAPTER ONE

1.0           INTRODUCTION

Staphylococcus contains four genera of which the genus Staphylococcus is the most important. This gram positive organism is a coccus and belongs to the family Staphylococcaceae, order; Bacillales, class; Coccus; phylum: Firmicutes and kingdom; Eubcteria (Cogston 1984). The organism appear as grape-like clusters when viewed through a microscope.

It is a commensalistic bacterium found in warm, moist areas of the body particularly the nose, axillae (armpit), skin, and perineum (Ray and Ryan, 2004). The organism have techoic acid in their cell wall and are catalase positive , oxidase negative as well as glucose ferments (Power, 1998; Bannerman, 2003). The genus has at last 30 species (Garrity, 2001). The main three species of clinical importance are Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus saprophyticus.

The organism can survive on domesticated animals such as dogs, cats and horses and can cause bumble foot in chickens. It can survive for hours to weeks or even months on dry environmental surfaces depending on strains (Cimolai, 2008).

Different patterns of carriage of this organism have been identified. There are individuals who always carry one type of strain of this organism. This group of people is called persistent carriers and they make up 20% of the human population. There are intermittent carriers who habour S. aureus intermittently and the strain changes with varying frequency. That is, once in a while those groups of individual are colonized by one type of S. aureus strains or another. The intermittent carriers make up 60% of the human population. These individuals who almost never carry S. aureus are called non-carriers and they make up about less than 20% of the human population (Kluytman et al, 1997).

Although S. aureus colonization of the nostril is asymptomatic, nasal carriage is a risk factors for subsequent infection particularly in surgical patients, intensive-care unit patient, patient with intravascular devices and human immunodeficiency virus positive individuals. (Kluytman et al, 1997).

S. aureus became known as a causative agent of infection when Alexander Ogston identified its role in sepsis absecess formation (Ogston, 1982). S. aureus can cause a range of illness from minor skin infection such as pimples, impetigo, boils, scalded skin syndrome and abscesses to life–threatening disease such as pnueumonia, meningitis, toxic shock syndrome (TSS), bacteremia and sepsis (Tenover and Gaynes, 2000).

The discovery of penicillin and many other antibiotics in the mid nineties created a sense of euphoria in the medical community as it perceived that bacteria infection were curable. However, the bright prospect of antimicrobial therapy began to dim when it became obvious that disease causing bacteria posses a repertoire of strategies against antimicrobial agents.

Staphylococcus aureus isolates acquired resistance to methicillin and is the principal cause of several Infections that are difficult to treat in humans. (Mernon, 2006). Methicillin-sensitive Staphylococcus aureus (MSSA) are strains unable to resist beta-lactam antibiotics, which include the penicillins (methicillin dicloxacillin, oxacillin, cloxacillin etc) and some cephalosporins. (Akoua, 2004).

MRSA is still a dominant hospital –associated pathogen (h-MRSA). However there are ongoing changes in the epidemiology of MRSA. In former times, MRSA strains were clonal and there were only a few epidemic strains. MRSA strains are now more heterogenous. In addition, there is an evolution of so–called community-acquired MRSA (CAMRSA) with characteristic distinct from those of the traditional h-MRSA. Genetically-methicillin – resistant S. aureus (MRSA) is produced when methicillin – susceptible S. aureus (MSSA) acquires a mobile genetic element, Staphylococcal cassette chromosome mec (S. CCmec). (Katayama, et al, 2000).

It is hypothesized that the evolution of CA-MRSA is a recent event due to the acquisition of mec DNA by previously methicillin-susceptible strains that circulated in the community. The prevalence of methicillin sensitive Staphylococcus aureus which is the basis of this study regularly occurs.

1.1       Aims and Objectives

i.          To determine the prevalence of methicillin sensitive Staphylococcus aureus isolated from the nostrils of students of Michael Okpara University of Agriculture, Umudike in Umuahia.

ii.         To determine the antibiotic sensitivity pattern of methicillin sensitive Staphylococuss aureus.

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