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Frequency and Diversity of Staphylococcal Cassette Chromosome mecElements in nasally Carried Methicillin Resistant Staphylococcus Aureus of Healthcare Workers

Amina Asif, Iffat Javed, Saeed Anwar, Sohaila Mushtaq

Abstract


Objective: To determine the frequency andSCCmec type of nasally carried MRSA in HCWs of a tertiary care hospital.

Materials and Methods: Nasal swabs were collected from three hundred and eighty healthcare workers working in various clinical wards of Lahore General Hospital, Lahore. Identification of Staphylococcus aureus was done by observing colony morphology and mannitol fermentation on mannitol salt agar, Gram stain, catalase test and DNase test. The phenotypic resistance to methicillin was determined using Cefoxitin disk 30 µg according to CLSI guidelines. All the isolates showing Cefoxitin resistance were confirmed for the presence ofmecA gene and typed for SCCmec I, II, III, IV (a, b, c, d) and V by PCR. For quality control and for the confirmation of the results, DNA sequencing was done for random isolates for all the SCCmec types recovered in the present study.

Results: Out of 380 nasal samples, 89 (23.42%) cultures yielded the growth of S. aureus out of which 31 (34.83%) were MRSA. The overall frequency of MRSA among all the HCWs was 8.2%. Overall 47 SCCmec elements were found in total 29 MRSA isolates. Out of 29 MRSA isolates, 13 (44.82%) were hospital acquired, 7 (24.13%) were community acquired and 9 (31.03%) isolates had SCCmec types of both hospital acquired and community acquired origins.

Conclusion: The colonized healthcare workers  harboring MRSA are being acting as mixing bowls of different SCCmec genes. Our study emphasizes the need for the formulation of regular nasal decolonization policies for effective infection control within our healthcare setups.


Keywords


MRSA; HA-MRSA; CA-MRSA; SCCmec

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