ABSTRACT
Methicillin-resistant Staphylococcus
aureus (MRSA) is a significant public health concern globally, and this
study aims to determine its prevalence among postgraduate students at Michael
Okpara University of Agriculture, Umudike, Nigeria. Additionally, the study
seeks to assess the antibiotic sensitivity profile of Staphylococcus aureus
isolates. A total of 100 nasal swabs were collected from students using sterile
swabs, which were then processed in the laboratory. Mannitol salt agar,
nutrient agar, and Muller Hinton agar were used to culture and identify S.
aureus based on Gram staining and biochemical tests such as coagulase and
catalase reactions.
The results indicated that Staphylococcus
aureus was isolated in all 100 samples, with 74% of the isolates
demonstrating resistance to oxacillin, signifying a high prevalence of MRSA.
The prevalence rate is consistent with prior studies in Nigeria but varies
depending on sample size and location. The high resistance to oxacillin is
likely due to the opportunistic nature of S. aureus and the misuse of
antibiotics. This resistance poses a public health risk, as MRSA carriers are
at an increased risk of spreading the infection, particularly in crowded
environments such as student hostels.
The study underscores the need
for improved hygiene practices and antibiotic stewardship to reduce the spread
of MRSA among students. Preventive measures, including proper hygiene, reduced
sharing of personal items, and rational use of antibiotics, are crucial in
curbing MRSA transmission. Additionally, educational programs should be
initiated to raise awareness about the dangers of antibiotic misuse. The study
highlights the critical need for health authorities to address overcrowding in
student hostels and implement MRSA control strategies, such as microbiological
surveillance and contact precautions
TABLE OF CONTENTS
CHAPTER ONE
INTRODUCTION
1.1
Aims and Objectives
CHAPTER TWO
2.0 LITERATURE
REVIEW
2.1 Staphylococus
aureus (S. aureus)
2.2 Mode of Reproduction
2.3 Role of S.
Aureus in Causing Disease
2.3.1 Toxic Shock Syndrome (TSS)
2.3.2 Skin Infections
2.3.3
Food Infections
2.4 Virulent Factors
2.5 Significance of S. Aureus in Nasal
Passages
2.6 Antibiotics Susceptibility and Resistance
2.7 Methicillin Resistant Staphylococcus Aureus (MRSA)
2.7.1 Mode
Of Transmission
2.7.2
Incubation Period
2.7.3
People at Risk of Acquiring MRSA Infections
2.7.4 Epidemiology
2.7.5 Pathogenesis
of S. Aureus
2.7.6
Prevention and Control of MRSA
CHAPTER THREE
3.0 MATERIALS AND METHODS
3.1 Source of Material and Collection
3.2
Preparation of Culture Media.
3.3 Isolation and Identification of S. Aureus.
3.4 Gram Stain Reaction:
3.5
Biochemical Analysis
3.6.1
Preparation of Turbidity Standard Equivalent to Mc Farland 0.5
3.6.2 Antibiotic Susceptibility Test
3.6.3
Measurement of Zone of inhibition
CHAPTER FOUR
4.0 RESULTS
CHAPTER FIVE
5.0 DISCUSSIONS AND CONCULSION
5.1 Discussions
5.2 Conclusion
5.3 Recommendation
References
Appendix
Figure
1: Staph on MSA
Figure
2: Staph on Nutrient Agar
Figure 3: Oxacillin
Antibiotic
CHAPTER ONE
INTRODUCTION
Staphylococcus aureus
is a common pathogenic commensal bacterium found in warm, moist areas of the
body particularly the nose, axillae, skin and perineum. The name Staphylococcus
is derived from the Greek word “staphyle” which means “bunch of grapes and”
“kokkos” which means “granule”. They appear as round (cocci) and firm
grape-like structures under the microscope (Ryan and Ray. 2004).
Staphylococcus aureus is a Gram-positive spherical bacterium approximately
1μm in diameter. Its cells form grape-like clusters, since cell division takes
place in more than one plane. It is often found as a commensal associated with
skin, skin glands and mucous membranes, particularly in the nose of healthy
individuals (Crossley and Archer, 1997). It has been estimated that on a rich
medium, S. aureus forms medium size “golden”colonies. On sheep blood
agar plates, colonies of S. aureus often cause β-hemolysis (Ryan and
Ray,2004). The golden pigmentation of S. aureus colonies is caused by
the presence of carotenoids and has been reported to be a virulence factor
protecting the pathogen against oxidants produced by the immune system (Liu et
al., 2005). Staphylococcus are facultative anaerobes capable of generating
energy by aerobic respiration and by fermentation which yields mainly lactic
acid. Staphylococcus sp. is catalase-positive, a feature differentiating
them from Streptococcus sp., and they are oxidase-negative and require
complex nutrients,e.g., many amino acids and vitamins B, for growth.
S.
aureus is a gram positive organism responsible
for causing skin infections and sometimes produces relatively minor skin
infections such as pimples and boils. Most individuals are colonized by this
bacterium, that is, the bacterium is present but is not causing disease
(Wilson, 2001). Staphylococcus aureus
is one of the main agents of nosocomial infections and is sometimes difficult
to treat with currently available active antimicrobials (Makoni, 2002).
Staphylococcus aureus has been
recognized as an epidemiologically important pathogen. Its pathogenic effect is
characterized by its ability to haemolyze blood, coagulate plasma and produce a
variety of extracellular enzymes and toxins.
. S. aureus is
present in the nasal passage, throat, hair and skin of healthy individuals
(Makoni, 2002).
Staphylococcus aureus, is
commonly found on the skin or in the nose of healthy people approximately 25%
to 30% of the population are colonized with staph bacteria (i.e., carry the
bacteria without becoming ill).
Sometimes Staphylococcus
causes a minor skin infection (pimple, pustule, or boil) that can be treated
conservatively, without antibiotics. However, on occasion, Staphyloccus
bacteria can cause more serious illnesses, such as infections involving soft
tissue, bone, the bloodstream or the lungs.
Over
the past years, treatment of some Staphylococcus infections has become more
difficult because the bacteria have become resistant to various antibiotics. S.
aureus that is resistant to methicillin/Oxacillin is called
methicillin-resistant Staphylococcal aureus (MRSA). Staphylococcus aureus is
considered to be one of the most important resistant pathogen and it was one of
the earliest microorganisms in which penicillin resistance was detected. Methicillin-resistant S. aureus became
a major threat. Methicillin was introduced in 1959 to treat infections but in
1961 shortly after the introduction of methicillin, Staphylococcus aureus isolates
which had acquired resistant to methicillin was reported. Methicillin resistant
Staphylococcus aureus (MRSA) is one of the greatly feared strains of S.
aureus. Its resistance to most antibiotics makes its treatment to last
longer and may include second- and third-tier drugs that are generally more
expensive and have greater side effects. MRSA is also known to be relatively
quick to mutate. According to Neihart et al., (1988), S. aureus strains
carry a wide variety of multidrug resistant genes on plasmid which can be
exchanged and spread among different species of Staphylococci.
MRSA
is a major cause of community and hospital acquired infection causing several
morbidity and mortality worldwide (Grundman et al., 2006; Vindel et
al., 2009).
Recently,
there has been a shift from it being a nosocomial pathogen as it is now
increasingly recovered from nursing homes, prisons, school environments and
communities. This shift might be associated with its mode of transmission which
is primarily by direct/indirect person to person contact and also by person to
surface contact (Fogg, 2002; Evans and Richard, 2009). Outbreaks of
community-associated (CA)–MRSA infections have been reported in correctional
facilities, among athletic teams, among military recruits, in newborn
nurseries, and among men who have sex with men (Chambers, 2001, Ellis et al.,
2004)
The
emergence of MRSA renders the treatment more challenging (Choi et al.,
2006) because they exhibit multiple drug resistance to unrelated antimicrobial
agents (Truckssis et al., 1991).There is evidence that
hospital acquired methicillin resistant Staphylococcus
aureus (HA-MRSA) infection increases
morbidity, mortality risks and costs (Cosgrove et al., 2005). MRSA was
associated with hospitals; however, it is now increasingly recovered from
homes, schools, offices, prisons and community.
Hospital
acquired MRSA (HA - MRSA) and community acquired MRSA (CA - MRSA) are the two
major groups causing MRSA infections.
MRSA has become a major cause of hospital acquired infection as CA –
MRSA emerged worldwide in 1990’s (Vandenesch et al., 2003). The spectrum of diseases caused by CA –MRSA
in the community is high. Skin and soft
tissue infections are the most frequent reported clinical manifestations
(Fridkin, 2005; Bagget, 2003).
Outbreaks
of community-associated (CA)–MRSA infections have been reported in correctional
facilities, among athletic teams, among military recruits, in newborn
nurseries, and among men who have sex with men (Chambers, 2001, Ellis et
al., 2004).
CA-MRSA
infections now appear to be endemic in many urban regions and cause most CA–S.
aureus infections (Eady and Cove, 2003; Moran et al., 2005). Denis et
al., (2004) reported that since 1995, MRSA isolates in Belgian hospitals
were losing resistance to older antimicrobial drugs such as gentamicin and
clindamycin. Some MRSA strains associated with CA infection have been noted to
cause Hospital Acquired (HA) infections (Saiman et al., 2003). Another
recent report demonstrated that CA strains had emerged as a substantial cause
of HA bloodstream infections (Seybold et al., 2006). The emergence of
CA-MRSA is of great concern to health officials but of greater concern is the
fact that strains frequently associated with community outbreaks are now
reported to be causing Hospital acquired infections. (Denis et al., 2004).
This in turn renders treatment of Staphylococcal infections more
challenging, considering the fact that MRSA are multidrug resistance
Hospital
acquired MRSA regularly occurs and shows little variations in its incidence.
Most colonized hospital patients; staff and professionals are transient
carriers but may become persistent carriers especially when they have skin
lesions. Thus the identification and treatment of colonized health
professionals and patient can reduce the incidence of hospital acquired MRSA,
as unidentified colonized patient can act as reservoir in endemic situations
(Ben-David et al., 2008).
The
need to follow the trend of this infection in my own community especially
amongst the post graduate students necessitated this work which is aimed at
determining the prevalence of MRSA amongst the post student community of
Michael Okpara University of Agriculture, Umudike, Nigeria.
1.1 AIMS AND OBJECTIVES
·
To determine the
prevalence of MRSA amongst the post graduate students of Michael Okpara
University of Agriculture Umudike, Nigeria.
·
To find out the
antibiotics sensitivity profile of the Staphylococcus
aureus isolate
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