INCIDENCE OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS ISOLATED FROM NOSTRILS OF STUDENTS

ABSTRACT

This study was carried out to determine the prevalence of nasal carriage of Staphylococcus aureus among Mouau students and determine the antibiotics susceptibility pattern. A total of 100 nasal swab samples were collected from 59 male and 41 female students of Michael Okpara University of Agriculture Umudike, Abia state. Nasal swabs specimens were collected from the anterior nares and cultured on Mannitol salt agar.  S. aureus isolates were identified by mannitol fermentation, coagulase positivity and catalase positivity. Antimicrobial susceptibility test was performed on Meuller-Hinton Agar (MHA) by modified Kirby-Bauer disc diffusion method. Out of the 100 nasal swabs collected, S. aureus was isolated in 60 (60%). Among the isolates, 63.3% (n=38) were from male students whereas 36.7% (n=22) were from female. The antibiotic susceptibility pattern of the Staphylococcus aureus Isolates indicates that Staphylococcus aureus isolates showed high rate of sensitivity towards antibiotics as follows; Gentamicin (81.67%), followed by Ciprofloxacin (80%), Levofloxacin (76.67%), Ceftriaxone (58.33%) and resistance towards antibiotics Imipenem (100%) followed by Cefotaxime (90%), Cefexime (83.33%), Cefoxitin (65%), Azithromycin (55%), and Cefuroxime (50%). In this study the rate of MRSA isolation was found to be 65%. The MRSA carriage rate was found to be 73.9% in the age group 19-21years, 60% in the age group 22-24years and 58.8% in the age group 16-18years.This study showed a high rate of nasal carriage of Staphylococcus aureus among Mouau students and high incidence of antibiotics resistant Staphylococcus aureus carriage. Finally, there is need to implement strategies for elimination of nasal carriage of methicillin resistant Staphylococcus aureus (MRSA), so as to prevent severe multi-drug resistant S. aureus infections in our environments

TABLE OF CONTENTS

Title Page                                                                                                                                 i

Certification                                                                                                                           ii

Dedication                                                                                                                              iii

Acknowledgements                                                                                                                iv

Table of Contents                                                                                                                   v

List of Tables                                                                                                                          vii

Abstract                                                                                                                                  viii

CHAPTER ONE

1.0       Introduction                                                                                                                1

1.1       Aims and Objectives                                                                                                  4

CHAPTER TWO                                                                                                     

2.0       Literature Review                                                                                                       5

2.1       Epidemiology of MRSA                                                                                             6

2.2       The Prevalence of S aureus Nasal Carriage                                                               6

2.3       Staphylococcus aureus                                                                                               8

2.4       Virulence Factors of S. aureus                                                                                   8

2.5       MRSA                                                                                                                         9

2.6       Modes of Transmission of MRSA                                                                              11

2.7       MRSA Colonization                                                                                                   12

2.8       MRSA Infection                                                                                                         12

2.8.1    Bacteremia                                                                                                                 13

2.8.2    Endocarditis                                                                                                                13

2.8.3    Metastatic Infections                                                                                                  13

2.8.4    Sepsis                                                                                                                          14

2.8.5    Toxic Shock Syndrome                                                                                              14

2.9       Public Health Burden of MRSA in Africa                                                                 14

CHAPTER THREE

3.0       Materials and Methods                                                                                               15

3.1       Study Area                                                                                                                  15

3.2       Collection of Samples                                                                                                15

3.3       Preparation of Culture Media                                                                                     15

3.4       Inoculation and Isolation                                                                                            16

3.5       Purification of Isolates                                                                                               16

3.6       Identification of the Isolates                                                                                       16

3.6.1    Gram Staining                                                                                                            16

3.6.2    Biochemical Test                                                                                                        17

3.6.2.1 Catalase Test                                                                                                               17

3.6.2.2 Coagulase Test                                                                                                           17       

3.7       Antibiotic Susceptibility Testing                                                                                17

CHAPTER FOUR

4.0       Results                                                                                                                        18

CHAPTER FIVE

5.0       Discussion and Conclusion                                                                                        22

5.1       Discussion                                                                                                                   22

5.2       Conclusion                                                                                                                  23

            References                                                                                                                  25

LIST OF TABLES

CHAPTER ONE

1.0       INTRODUCTION

Staphylococcus. aureus causes a variety of suppurative infections and toxinoses in humans. It causes superficial skin lesions such as boils, styes and furuncules; more serious infections such as pneumonia, mastitis, phlebitis, meningitis, and urinary tract infections; and deep-seated infections, such as osteomyelitis and endocarditis. S. aureus is a major cause of hospital acquired (nosocomial) infection of surgical wounds and infections associated with indwelling medical devices. S. aureus causes food poisoning by releasing enterotoxins into food, and toxic shock syndrome by release of super-antigens into the blood stream (Edward et al., 2013).

Although methicillin-resistant S. aureus (MRSA) has been entrenched in hospital settings for several decades, methicillin-resistant S. aureus MRSA strains have recently emerged outside the hospital becoming known as community associated- methicillin-resistant S. aureus ( (CA-MRSA) or superbug strains of the organism, which now account for the majority of staphylococcal infections seen in the clinic (Emaneini et al., 2016).

The primary reservoir of staphylococci is the nares, with colonization also occurring in the axillae, vulva, pharynx, and other skin surfaces. Nasal carriage in patient admitted to the hospital is common because close contact among patients and hospital personnel is not unusual; transfer of organisms often takes place. Increased colonization in patients and hospital workers frequently occurs in hospitals. Both hospital and community-acquired infections caused by drug resistant S. aureus have increased in the past 20 years (Espinosa-Gongora et al., 2015).

S. aureus is both a human commensal and a frequent cause of clinically important infections. It is frequently found on the human respiratory tract and on the skin. Strains that are associated with disease often result in infections by producing potent protein toxins, and expressing cell-surface proteins that bind and inactivate antibodies. The emergence of antibiotic-resistant forms of pathogenic S. aureus (e.g. MRSA)) is a worldwide problem in clinical medicine. S. aureus screening, today, is mainly done to identify methicillin-resistant S. aureus (MRSA) carriers. The prevalence of methicillin-resistant S. aureus (MRSA) is still quite low in some parts of the world, such as Northern European countries, but there is a worldwide increase in the number of infections caused by methicillin-resistant S. aureus (MRSA) (Emaneini et al., 2016). Almost 25% of the Health Care Workers are stable nasal carriers, and 30% to 50% of them also possess the bacteria on their hands. Health Care Workers that carry S. aureus in their nares can occasionally cause outbreaks of surgical-site infections (Agumas et al., 2013). Most of the invasive S. aureus infections are assumed to arise from nasal carriage (Calfee et al., 2014).

Staphylococcus aureus is one of the most important pathogens worldwide and has emerged as a prominent organism infecting critically ill persons; the impact of S. aureus infection on human health has dramatically increased as a result of its remarkable ability to become resistant to antimicrobials. Because of its primary habitat is moist squamous epithelium of the anterior nares, most invasive S. aureus infections are assumed to arise from nasal carriage (Annati et al., 2013). The difference between methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus is resistance to ß-lactam antibiotics; this is often associated with resistance to multiple other antibiotics, which limits the therapeutic options (Castro et al., 2016).

National estimates in the United States from 2000-2002 suggested that the prevalence of S. aureus and methicilin resistant S. aureus (MRSA) colonization ratios were 31.6% and 0.84%, respectively. And about 7% or more of patients admitted to the hospital are colonized with MRSA. Although asymptomatic nasal colonization with S. aureus is common, it appears to be an important factor in the development of most infections due to this organism (Ahanjan et al., 2014).

S. aureus is the most clinically significant species of staphylococci; S. aureus characteristics gave the reason for their pathogenicity; which takes many forms. They grow comparatively well under conditions of high osmotic pressure and low moisture, which partially explains why they can grow and survive in nasal secretions and on the skin. S. aureus has been recognized as an important cause of disease around the world and it has become a major pathogen associated with both hospital and community acquired infections (De-Boeck et al., 2015).

Antimicrobial resistance developed by pathogenic organisms is a global menace and has escalated over the years by the emergence of multi-drug resistant strains among these pathogens (Lister et al., 2009). Development of resistance to antimicrobial agents by pathogens is a fitness trait acquired to survive in whatever environment they find themselves. This evolution trait (survival of the fittest) has accounted for the unparallel success of microbial existence in any part of the earth irrespective of the extreme conditions (De-Boeck et al., 2015). Bacteria may possess intrinsic resistance that protect them from a particular antibiotic; or acquire resistance through chromosomal mutation or acquisition of genetic materials from other bacteria either through vertical or horizontal transfer of genes. This has lead to some strains being called superbugs due to acquisition of resistant genes to different classes of antibiotics, making their treatment highly problematic for both the clinicians and patients. Antimicrobial resistant infections can be acquired in health care facilities, in the community or through food supply (De-Boeck et al., 2015). Globalization also makes possible the easy spread of these pathogenic organisms from one country to other countries. Examples of clinically important pathogens that are increasingly becoming multi-drug resistance to antibiotics in use are Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterococcus faecalis. The treatment of infectious diseases caused by microorganisms that have become resistant to commonly used antibiotics has become a major global health care problem in the 21st century (Luzhetskyy et al., 2007). Microbial resistance to drugs was recorded early in the history of chemotherapy and post introduction of penicillin into medical practice; resistant bacteria emerged rendering the “magic drug” ineffective, a pattern the microbes maintained for many years. However, over the past decades microbes have proved themselves to be adapted at becoming resistant to each new antimicrobial agent produced by man (Bergstrom, 2011).

1.1       AIMS AND OBJECTIVES

This aim of this study is to determine the incidence of methicilline resistant Staphylococcus aureus isolated from the nostrils of Adults

The objectives are;

•       To isolate and identify Staphylococcus aureus obtained from the nose of Mouau students.

•       To determine the percentage occurrence of the Staphylococcus aureus isolates.

•       To study the antibiotic susceptibility pattern of the Staphylococcus aureus isolates.

•       To determine MRSA carriage rate among the Staphylococcus aureus isolates obtained from the nose of Mouau students

Buyers has the right to create dispute within seven (7) days of purchase for 100% refund request when you experience issue with the file received. 

Dispute can only be created when you receive a corrupt file, a wrong file or irregularities in the table of contents and content of the file you received. 

ProjectShelve.com shall either provide the appropriate file within 48hrs or send refund excluding your bank transaction charges. Term and Conditions are applied.

Buyers are expected to confirm that the material you are paying for is available on our website ProjectShelve.com and you have selected the right material, you have also gone through the preliminary pages and it interests you before payment. DO NOT MAKE BANK PAYMENT IF YOUR TOPIC IS NOT ON THE WEBSITE.

In case of payment for a material not available on ProjectShelve.com, the management of ProjectShelve.com has the right to keep your money until you send a topic that is available on our website within 48 hours.

You cannot change topic after receiving material of the topic you ordered and paid for.