Inducible clindamycin resistance and nasal carriage rates of Staphylococcus aureus among healthcare workers and community members

Afr Health Sci. 2015 Sep;15(3):861-7. doi: 10.4314/ahs.v15i3.21.

Abstract

Background: Nasal carriage of Staphylococcus aureus is becoming an increasing problem among healthcare workers and community individuals.

Objectives: To determine the prevalence of methicillin-resistant S. aureus (MRSA) nasal colonization and inducible clindamycin resistance (ICR) of S. aureus among healthcare workers at Soba University Hospital and community members in Khartoum State, Sudan.

Methods: Five hundred nasal swabs samples were collected during March 2009 to April 2010. Isolates were identified using conventional laboratory assays and MRSA determined by the disk diffusion method. The D-test was performed for detection of ICR isolates with Clinical Laboratory Standard Institute guidelines.

Results: Of the 114 S. aureus isolated, 20.2% represented MRSA. The occurrence of MRSA was significantly higher among healthcare worker than community individuals [32.7% (18/55) vs. 6.9% (5/59)] (p=0.001). Overall the 114 S. aureus isolates tested for ICR by D-test, 29 (25.4%) yielded inducible resistance. Significantly higher (p=0.026) ICR was detected among MRSA (43.5%) than methicillin-susceptible S. aureus (MSSA) (20.9%).

Conclusion: MRSA nasal carriage among healthcare workers needs infection control practice in hospitals to prevent transmission of MRSA. The occurrence of ICR in S. aureus is of a great concern, D- test should be carried out routinely in our hospitals to avoid therapeutic failure.

Keywords: S. aureus nasal carriage; community members; healthcare workers; inducible clindamycin resistance.

Publication types

  • Comparative Study

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Carrier State / epidemiology*
  • Clindamycin / pharmacology*
  • Health Personnel / statistics & numerical data*
  • Humans
  • Infectious Disease Transmission, Professional-to-Patient / prevention & control*
  • Methicillin Resistance
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Microbial Sensitivity Tests
  • Nose / microbiology
  • Prevalence
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / drug effects*
  • Staphylococcus aureus / isolation & purification
  • Sudan / epidemiology

Substances

  • Anti-Bacterial Agents
  • Clindamycin