NASAL CARRIAGE OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS AMONG FOOD HANDLERS IN UMUDIKE

ABSTRACT

The Prevalence of methicilin resistant Staphylococcus aureus was assessed among food handlers in Umudike. Nasal swabs were collected from 50 food handlers made up of 9 males and 41 females. Forty two (84%) of samples yielded growth with 35(70%) identified as Staphylococcus aureus.  The Antibiotic sensitivity of the isolates was done using Kirby-Bauer technique with ABTEK antibiotic susceptibility kit containing 8 antibiotics; Ceftazidine(30ug), Cloxacillin(5ug), Augumentin(30ug), Cefuroxime(30ug), Gentamicin(10ug), Ofloxacin(5ug), Erythromycin(5ug) and Ceftriaxone(30ug). 35 (100%) of the isolates were resistant to Ceftazidine, Cloxacillin, Augumentin and Cefuroxime. The isolates were sensitive to Gentamicin 13(37%) and Ofloxacin 7(20%). This study indicates that the multi drug Methicillin (Cloxacillin) resistant Staphylococcus aureus strains are wide spread among food handlers and the need for maintenance of good   hygiene practices by food handlers should be emphasized to avoid an increased rate of transmission to consumers.

TABLE OF CONTENTS

Title page i

Certification ii

Acknowledgment iii

Abstract iv

Table of contents                                                                                                                     v

List of tables             vi

CHAPTER ONE

1.0 Introduction 1

1.2 Aims and objective 4

CHAPTER TWO

2.0 Literature Review 5

2.1 Characteristic of Staphylococcus aureus 7

2.2 Pathogenesis of S.aureus 8

2.3 How does S.aureus reach the nose 9

2.4 Antibiotic resistance and susceptibility 9

2.5 Virulence factor 10

2.6 Methicillin resistant Staphylococcus aureus 12

2.7 Risk group 14

2.7 Prevention and control 15

CHAPTER THREE

3.0 Materials and methods 18

3.1 Study area 18

3.2 Sample collection 18

3.3 Media used 18

3.4 Preparation of culture media 18

3.5 Inoculation and isolation of S.aureus 19

3.6 Identification and confirmation of S.aureus 19

3.6.1 Gram staining 19

3.6.2 Biochemical test 20

  3.7   Antibiotic susceptibility testing 21

3.7.1 Reading of zone of inhibition 21

CHAPTER FOUR

4.0 Results 22

CHAPTER FIVE

5.0 Discussion and Recommendation 28

5.1 Discussion 29

5.2 Conclusion 29

5.3 Recommendation                         30

References

Appendix

LIST OF TABLES

Table  Title Page 

 1    Characterization and Identification of Staphylococcus aureus   23

 2                 The nasal carriage of Staphylococcus aureus among food handlers 24

                     in Umudike.

 3                  The sex distribution and Antimicrobial susceptibility profile             25

of Staphylococcus aureus isolates.

 4 Percentage effectiveness of the different antibiotics used against 26

                      Staphylococcus aureus.

 5                   Percentage Occurrence of Methicillin.(Cloxacillin) resistant  27

Staphylococcus aureus

CHAPTER ONE

1.0 INTRODUCTION

Staphylococcus aureus is widely distributed in the soil, air, water and dust. It is catalase positive (i.e. it can produce enzyme catalase) so it is able to convert hydrogen peroxide (H ₂O₂) to H₂O and O₂ which helps to differentiate Staphylococci from Enterococci and Streptococci. Majority of Staphylococcus aureus are coagulase positive and they occur as commensal on the skin and the body orifices such as the anterior nares, ear and mouth cavity (Nwankwo, 2001).

Humans interact with organism because the human body represents several environmental niches for bacteria providing warmth, moisture and food necessary for their development. One of the most important bacteria in normal human microbiota is Staphylococcus aureus which have been isolated from body parts including hands and mouth (Sidney et al., 2013).

It is a large filled space to keep foreign and unwanted particles from entering the lungs through the nares. The nares environment is colonized by temporarily stable microbiota that is distinct from other regions of the integument. Negative association between Staphylococcus specie suggest microbial competition during colonization of the nares; a finding that could be exploited to limit Staphylococcus aureus colonization (Frank, 2010).

 Food handlers play a major role in the transmission of food borne diseases which represents a global health burden. According to World Health organization, up to 30% of the population of developed countries are affected by food borne illness each year whereas in developing countries up to two million are estimated per year (WHO, 2007). The problem is more widely spread in developing countries where most of these cases are not reported thus the true dimension is not known (WHO,2007) Food handlers are potential causes of infections by many food borne pathogens since many diseases are communicable and caused originally by microorganisms carried into their bodies (Zain et al., 2002). The spread of food borne disease via food handlers are a common and persistent problem worldwide (Scott, 2003).It is estimated that 30-50% of the human population carries Staphylococcus aureus and its main habitat is the nasopharynx, a site where strains can persist as transitory or persistent members of the normal microbiota without causing any symptoms. The nasal cavity is an ecosystem suitable for growth and inter- relationship of the microorganism showing colonies with different phagocytes (Sidney et al., 2013). The nostrils provide an environment in which Staphylococcus aureus can propagate and remain for extended period of time. The nasal cavity is an ecosystem suitable for growth and inter- relationship of the microorganism showing colonies with different phagocytes (Sidney et al., 2013).

The nasal carriage of Methicillin resistant Staphylococcus aureus (MRSA) is recognized as a risk factor for the acquisition of an endogenous infection and play an important role in the spread of this pathogen not only in the hospital care units but in community as well (Klutymans, 1997). Accordingly, body carriage of Staphylococcus aureus by food handlers can be an important source of contamination of the food product via respiratory secretions or direct contact via hands during food handling. Currently, a significant number of S. aureus species that infect humans and animals are those isolated from nasal passages and has exhibited some degree of antimicrobial resistance (Cheesbrough, 2010).

1.2 AIMS AND OBJECTIVES

· To assess the prevalence of nasal carriage of Staphylococcus aureus among food handlers in Umuahia.

· To determine the prevalence of methicillin resistance of  Staphylococcus aureus (MRSA)

· To determine the antibiotic susceptibility profile of Staphylococcus aureus isolates.

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