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Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
Published on: May 8, 2013
Detection of Panton-Valentine Leukocidin-Positive Methicillin-Resistant Staphylococcus aureus Nasal Carriage among
Enas Mamdouh Hefzy1, Gamal Mohamedin Hassan2, Fadwa Abd El Reheem3
11 Department of Medical Microbiology and Immunology, Faculty of Medicine, Fayoum University , Fayoum, Egypt .
Background:
Transmission of methicillin-resistant Staphylococcus aureus (MRSA) among patients is linked mainly to health care personnel. The Panton-Valentine leukocidin (PVL) is a cytotoxin that causes leukocyte lysis. Virulence of pvl-positive-MRSA has been attributed to its ability to express PVL toxin.
Methods:
Swabs for detection of nasal carriage of pvl-positive MRSA among health care personnel at Fayoum University Hospital, Fayoum, Egypt, were collected from 223 health care personnel including 70 doctors (31.4%), 95 nurses (42.6%), 21 laboratory technicians (9.4%), and 37 housekeeping staff (16.6%). Detection of MRSA was done using conventional screening methods and confirmed by multiplex polymerase chain reaction (PCR) for mecA, or its homologue mecC, and pvl genes amplification. Re-swabbing after decolonization therapy was done to evaluate the efficacy of decolonization therapy.
Results:
Fifty-one of 223 participants (22.9%) were colonized with S. aureus. This included 13.5% (30/223) colonized with MRSA and 2.2% (5/223) colonized with PVL-positive MRSA. Moreover, all MRSA isolates were negative for mecC genes. Decolonization therapy was successful in 80% of MRSA carriers including all pvl-positive MRSA carriers.
Conclusions:
This is the first report on nasal carriage of pvl-positive MRSA among Egyptian health care personnel. High carriage rate of MRSA among health care personnel has been attributed mainly to poor hand hygiene compliance and non-judicious use of antibiotics. Improving compliance, reducing antibiotic overuse, screening for carriers, and decolonization are recommended strategies for reducing the spread of MRSA. Multiplex PCR could be used for confirmation of results obtained by conventional phenotypic methods.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage was found in 13.5% of Egyptian healthcare workers, with 2.2% carrying PVL-positive MRSA. Decolonization therapy proved effective for MRSA carriers, including those with PVL-positive strains.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Healthcare personnel are a primary source for methicillin-resistant Staphylococcus aureus (MRSA) transmission.
- Panton-Valentine leukocidin (PVL) is a cytotoxin contributing to the virulence of PVL-positive MRSA strains.
Purpose of the Study:
- To investigate the prevalence of nasal carriage of PVL-positive MRSA among healthcare personnel in Egypt.
- To evaluate the efficacy of decolonization therapy for MRSA carriers.
Main Methods:
- Conventional screening and multiplex PCR were used to detect MRSA and PVL genes in nasal swabs from 223 healthcare personnel.
- Participants included doctors, nurses, laboratory technicians, and housekeeping staff.
- Decolonization therapy efficacy was assessed through re-swabbing.
Main Results:
- Overall S. aureus colonization was 22.9%, with 13.5% carrying MRSA and 2.2% carrying PVL-positive MRSA.
- All MRSA isolates were negative for mecC genes.
- Decolonization therapy was successful in 80% of MRSA carriers, including all PVL-positive MRSA carriers.
Conclusions:
- This study is the first to report PVL-positive MRSA nasal carriage in Egyptian healthcare personnel.
- High MRSA carriage rates are linked to poor hand hygiene and antibiotic overuse.
- Recommended strategies include improved compliance, reduced antibiotic use, carrier screening, and decolonization.
