ROLE OF CARE GIVERS IN TRANSMISSION OF METHICILLIN RESISTANT Staphylococcus aureus IN PEDIATRICS DEPARTMENT IN ONDO STATE SPECIALIST HOSPITAL, AKURE

Abstract

A total number of 136 samples from different sites (beddings, palms of care givers, incubators, door handles and drip stands) at the Pediatrics Department of the Ondo State Specialist Hopital, Akure were collected and cultured on nutrient agar and manitol salt agar. S. aureus was the highest occurring organism with a record of 52.3% followed by S. epidermidis with 19.5% and the lowest occurring organisms (Escherichia coli, Proteus mirabilis, Pseudomonas aeeruginosa) with 1.6%. Other organisms isolated are B. cereus (10.9%), Klebsiella pneumoniae (7.8%), Micrococcus luteus (2.3%), and Serratia marcescens (2.3%). Antibiotic sensitivity test was carried out on all the organisms using four common antibiotics, Tetracycline (TET), Ampicillin (AMP), Chloramphenicol (CHL), and Ciprofloxacin (CPX). The results showed that bacteria isolated from beddings has the lowest percentage multiple antibiotic resistance to all antibiotics used which includes CPX, TET, CHL, AMP. Bacteria isolated from drip stands shows higher percentage multiple antibiotic resistance to CPX and TET, compared to CHL and AMP, bacterial isolated from incubators shows higher percentage multiple antibiotic resistance to CPX, TET, CHL, and AMP, bacteria isolated from door handles shows higher percentage multiple antibiotic resistance to AMP, CHL, and CPX, compared to TET, and bacterial isolated from palms of family care givers shows higher resistance to AMP compared to CPX, TET, and CHL. Generally, pathogens showed high level of resistance to tetracycline (TET), followed by ampicillin (AMP) and ciprofloxacin (CPX) and low level of resistance to Chloramphenicol (CHL). Vancomycin (VAN), Oxacillin (OXA), and Cefoxitin (CEF) single disc diffusion test was used for the detection of Methicillin Resistant Staphylococcus aureus (MRSA) and Vancomycin Resistnt Staphylococcus aureus (VRSA). S. aureus that showed multiple resistance to the four common antibiotics were subjected to this test. . Ten (10) out of the twenty S. aureus were resistant to Vancomycin, that is, there was 50% resistance to Vancomycin out of which 80% of the 10 S. aureus that showed resistance to Vancomycin were from Parents, 10% from door handles and the other 10% from Nurses. Also four (4) out of the twenty S. aureus were resistant to Oxacillin, that is, there was 25% resistance to Oxacillin out of which 75% of the 4 S. aureus that showed resistance to Oxacillin were from Parents and 25% from Nurses. All the 4 S. aureus that showed resistant to Oxacillin were further subjected to Cefoxitin as a surrogate marker for the detection of MRSA and 100% resistance was recorded. Plasmid analysis was carried out on the four (4) MRSA and result showed that three (3) out of four (4) isolates harbored plasmid, with one or more plasmid bands. However, most of the resistance of S. aureus is highly associated with the indiscriminate use of antibiotics which has resulted to high level of drug resistance. Therefore, Sensitization of care givers about indiscriminate use of antibiotics, and regular hand washing by care givers is recommended, since they play important role in the transmission of MRSA.