Nasal Carriage of Staphylococcus and MRSA with Their Mupirocin Susceptibility among Students in Healthcare Settings

Objectives: Colonisation of healthcare workers' anterior nares is one of the possible risk factors for nosocomial staphylococcal and Methicillin-resistant Staphylococcus aureus (MRSA) infections. These infections can spread to patients from there and put a strain on the healthcare system. In this regard, an attempt was made to compare the nasal carriage of Staphylococcus and MRSA, as well as their Mupirocin susceptibility, in students who are exposed to the healthcare system and those who are not.

Background: MRSA strains, with their nasal colonization, are well known for their high tendency to spread among the HCWs and from them to the patients, which in turn may lead to an increase in the treatment cost burden by prolonging the duration of hospital stays or the administration of expensive medications and spreading in the community.

Methods: Nasal swabs were collected from 100 paramedical students as the study group and 100 non-medical students as the control group, all in the age group between 18 and 21 years. 5% sheep blood agar and mannitol salt agar were used to isolate S. aureus, and antibiotic sensitivity was done by Kirby Bauer Disc Diffusion Technique. Cefoxitin disc (30
g) and Vancomycin screen agar were used to detect MRSA and Vancomycin resistance, respectively. A 5
g disc of Mupirocin was used to test the low-level resistance to Mupirocin and a 200
g disc was used to test high-level resistance.

Results: The nasal carriage rate of S. aureus and MRSA was 23% and 8% in paramedical students and 17% and 4% in nonmedical students respectively. 83% of isolates from paraclinical students and 95% of isolates from non-medical students were susceptible to linezolid. Out of 12 MRSA strains from both groups, only one strain showed resistance to Mupirocin.

Conclusions: Nasal carriage of S. aureus and MRSA and antibiotic resistance of isolated strains were more common in paramedical students compared to non-medical students. Mupirocin resistance, even in a single case, needs to be addressed. Thus, it is advisable for the infection control team to routinely perform MRSA surveillance and to do nasal decolonization of healthcare workers to prevent the spread of infections among admitted patients.