THE PREVALENCE OF METHICILLIN-RESISTANT STAPHYLOCOCCAL AUREUS (MRSA) AMONGST THE POST STUDENT COMMUNITY OF MICHAEL OKPARA UNIVERSITY OF AGRICULTURE, UMUDIKE, NIGERIA.

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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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