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Methicillin-resistant staphylococcus aureus nasal colonization among health care workers of a tertiary hospital in ecuador and associated risk factors

Abstract:

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to most of the commonly used antibiotics and is therefore a public health issue. Colonization with MRSA is a risk factor for infection or transmission. Purpose: To determine the prevalence of colonization with Staphylococcus aureus (SA) and MRSA strains in health care workers (HCWs) at a tertiary hospital in Ecuador and to determine the risk factors associated with carriage. Methods: Out of a cohort of 3800 HCWs, 481 individuals from different hospital departments were randomly selected, and a single nasal swab was collected. Detection of SA and MRSA was carried out with the LightCycler® MRSA Advanced Test. A questionnaire was performed that gathered demographic and occupational information of the participants to determine risk factors for MRSA colonization. Statistical analysis was performed with univariate and multivariate analysis and the R-software version 4.0.2. Results: Colonization with SA and MRSA occurred in respectively 23.7% (95% CI, 22.7– 24.6) and 5% (95% CI, 3.39–7.58) of the individuals. The multivariate analysis showed that being older in age (OD 1.09) and being male (OD 2.78) were risk factors for SA and MRSA colonization (p-value < 0.001). Previous use of antibiotics or the use of nasal ointments diminished the colonization rates of SA (24% versus 3.7% and 10.1% respectively). Conclusion: About 20% of the HCWs who were colonized with SA were colonized with MRSA, representing a risk for nosocomial infections and hospital outbreaks. Active monitoring and a decolonization treatment of the HCWs can reduce these risks.