Research Article
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Year 2020, Volume: 42 Issue: 3, 259 - 270, 27.10.2020

Fikriye Milletli Sezgin , Sevgi Sarıhan Havva Nur Türkoğlu Melihcan Yağmur Gülgüşa Bucak Nida Şvval Büyüktatar Semih Mert Şener Sıla Nur Şehnaz Naime Meriç Konar , Mustafa Kasım Karahocagil

https://doi.org/10.7197/cmj.vi.645617

Abstract

Supporting Institution

Kırşehir Ahi Evran Üniversitesi Bilimsel Araştırma Projeleri Ofisi

Project Number

TIP.A4.19.008

References

  • Referans1. Becker K, von Eiff C. Staphylococcus, micrococcus, and other catalase-positive cocci. In: Versalovic J, Carroll KC, Jorgensen JH, Funke G, Landry ML, Warnock DW (eds). Manual of Clinical Microbiology. 10th ed. Washington DC: ASM Pres, 2011:308-31.
  • Referans2. Kluytmans J, van Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev. 1997;10:505–20.
  • Referans3. Carroll KC. Rapid diagnostics for methicillin-resistant Staphylococcus aureus: current status. Mol Diagn Ther. 2008;12:15-24.
  • Referans4. Appelbaum PC. Microbiology of antibiotic resistance in Staphylococcus aureus. Clin Infect Dis. 2007;45(Suppl. 3):S165-S170.
  • Referans5. Naimi TS, LeDell KH, Como-Sabetti K, Borchardt SM, Boxrud DJ, Etienne J, et al. Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA. 2003;290:2976–84.
  • Referans6. Crawford SE, David MZ, Glikman D, King KJ, Boyle-Vavra S, Daum RS. Clinical importance of purulence in methicillin-resistant Stapylococcus aureus skin and soft tissue infections. J Am Board Fam Med. 2009;22:647-54.
  • Referans7. Dulon M, Peters C, Schablon A, Nienhaus A. MRSA carriage among healthcare workers in non-outbreak settings in Europe and the United States: a systematic review. BMC Infect Dis. 2014;14:363.
  • Referans8. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 8, 2018. http://www.eucast.org.
  • Referans9. Guclu E, Yavuz T, Tokmak A, Behcet M, Karali E, Ozturk O, et al. Nasal carriage of pathogenic bacteria in medical students: effects of clinic exposure on prevalence and antibiotic susceptibility. Eur Arch Otorhinolaryngol. 2007;264:85–8.
  • Referans10. Dağı HT, Fındık D, Demirel G, Arslan U. Detection of methicillin resistance and various virulence factors in Staphylococcus aureus strains isolated from nasal carriers. Balkan med j. 2015;32:171-5.
  • Referans11. Al-Tamimi M, Himsawi N, Abu-Raideh J, Al-jawaldeh H, Mahmoud SAH, Hijjawi N, et al. Nasal colonization by methicillin-sensitive and methicillin-resistant Staphylococcus aureus among medical students. J Infect Dev Ctries. 2018;12:326-35.
  • Referans12. Chen BJ, Xie XY, Ni LJ, Dai XL, Lu Y, Wu XQ, et al. Factors associated with Staphylococcus aureus nasal carriage and molecular characteristics among the general population at a Medical College Campus in Guangzhou, South China. Ann Clin Microbiol Antimicrob. 2017;16:28.
  • Referans13. Budri PE, Shore AC, Coleman DC, Kinnevey PM, Humpreys H, Fitzgerald-Hughes D. Observational cross-sectional study of nasal staphylococcal species of medical students of diverse geographical origin, prior to healthcare exposure: prevalence of SCCmec, fusC, fusB and the arginine catabolite mobile element (ACME) in the absence of selective antibiotic pressure. BMJ open. 2018;8(4):e020391.
  • Referans14. Treesirichod A, Hantagool S, Prommalikit O. Nasal carriage and antimicrobial susceptibility of Staphylococcus aureus among medical students at the HRH Princess Maha Chakri Sirindhorn Medical Center, Thailand: a follow-up study. J Infect Public Health. 2014;7:205-9.
  • Referans15. Ahmadi S, Desa MNM. Staphylococcus aureus nasal carriers among medical students in a medical school. Med J Malaysia. 2012;67:636-8.
  • Referans16. Bettin A, Causil C, Reyes N. Molecular identification and antimicrobial susceptibility of Staphylococcus aureus nasal isolates from medical students in Cartagena, Colombia. Braz J Infect Dis. 2012;16;329-34.
  • Referans17. Ansari S, Gautam R, Shrestha S, Ansari SR, Subedi SN, Chhetri MR. Risk factors assessment for nasal colonization of Staphylococcus aureus and its methicillin resistant strains among pre-clinical medical students of Nepal. BMC Res Notes. 2016;9: 214.
  • Referans18. Abroo S, Jazani NH, Sharifi Y. Methicillin-resistant Staphylococcus aureus nasal carriage between healthy students of medical and nonmedical universities. Am J Infect Control. 2017;45:709-12.
  • Referans19. Bischoff WE, Wallis ML, Tucker KB, Reboussin BA, Sherertz RJ. Staphylococcus aureus nasal carriage in a student community prevalence, clonal relationships, and risk factors. Infect Control Hosp Epidemiol. 2004;25:485-91.
  • Referans20. Chen CS, Chen CY, Huang YC. Nasal carriage rate and molecular epidemiology of methicillin-resistant Staphylococcus aureus among medical students at a Taiwanese university. Int J Infect Dis. 2012;16:e799-803.
  • Referans21. Doebbeling B, Reagan D, Pfaller M, Houston AK, Hollis RJ, Wenzel RP. Long-term efficacy of intranasal mupirocin ointment. A prospective cohort study of Staphylococcus aureus carriage. Arch Intern Med. 1994;154:1505–8.
  • Referans22. Kalmeijer MD, Coertjens H, van Nieuwland-Bollen PM, Bogaers-Hofman GA, De Baere A, Stuurman A, et al. Surgical site infections in orthopedic surgery: the effect of mupirocin nasal ointment in a double-blind, randomized, placebo-controlled study. Clin Infect Dis. 2002;35:353–8.
  • Referans23. Gualdoni GA, Lingscheid T, Tobudic S, Burgmann H. Low nasal carriage of drug-resistant bacteria among medical students in Vienna. GMS Krankenhhyg Interdiszip. 2012;7.
  • Referans24. Cirković I, Djukić S, Vuković D, Stevanović G, Svabić-Vlahović M, Stepanović S. Nasal carriage of methicillin-resistant Staphylococcus aureus among medical students of Belgrade University. Srp Arh Celok Lek. 2013;141:349-53.
  • Referans25. Okamo B, Moremi N, Seni J, Mirambo MM, Kidenya BR, Mshana SE. Prevalence and antimicrobial susceptibility profiles of Staphylococcus aureus nasal carriage among pre-clinical and clinical medical students in a Tanzanian University. BMC Res Notes. 2016;9:47.
  • Referans26. Sarkar A, Raji A, Garaween G, Soge O, Rey-Ladino J, Al-Kattan W, et al. Antimicrobial resistance and virulence markers in methicillin sensitive Staphylococcus aureus isolates associated with nasal colonization. Microb pathog. 2016;93:8-12.
  • Referans27. Orlin I, Rokney A, Onn A, Glikman D, Peretz A. Hospital clones of methicillin-resistant Staphylococcus aureus are carried by medical students even before healthcare exposure. Antimicrob Resist Infect Control. 2017;6:15.

Nasal Carriage of Staphylococcus aureus by medical students: assessment of antibiotic susceptibility and risk factors

Year 2020, Volume: 42 Issue: 3, 259 - 270, 27.10.2020

Fikriye Milletli Sezgin , Sevgi Sarıhan Havva Nur Türkoğlu Melihcan Yağmur Gülgüşa Bucak Nida Şvval Büyüktatar Semih Mert Şener Sıla Nur Şehnaz Naime Meriç Konar , Mustafa Kasım Karahocagil

https://doi.org/10.7197/cmj.vi.645617

Abstract

Objective: Staphylococcus aureus (S. aureus) is the leading vector for both hospital-sourced and population-sourced infections globally and nasal carriage may be responsible for these serious infections. The aim of this study was to assess the nasal S. aureus carriage rates, antibiotic susceptibility and risk factors among preclinical period medical students.
Method: A total of 183 preclinical period students from Ahi Evran University Faculty of Medicine voluntarily participated in our study. They were requested to complete a survey form containing questions about demographic information, hygiene habits and medical history and possible risk factors were recorded. S. aureus isolates proliferating from nasal swab culture samples were studied with antibiotic susceptibility tests.
Results: Of the total of 183 students, 39 (21.4%) had S. aureus proliferation identified from nasal swab samples. None of these isolates were methicillin-resistant S. aureus (MRSA). Antibiotic susceptibility tests found highest resistance against penicillin (85%). There were negative correlations between nasal spray use and allergy history with nasal S. aureus carriage.
Conclusions: Medical students may each be mobile sources of bacteria in hospitals, especially as MRSA carriers. According to our results, it is necessary to note the importance of training and standard infection control precautions to prevent the increase in MRSA carriage rates in the clinical period as none of our preclinical period students carried MRSA. Advanced studies are important to monitor carriage rates.

Keywords

Staphylococcus aureus Nasal carriage Medical students

Project Number

TIP.A4.19.008

References

  • Referans1. Becker K, von Eiff C. Staphylococcus, micrococcus, and other catalase-positive cocci. In: Versalovic J, Carroll KC, Jorgensen JH, Funke G, Landry ML, Warnock DW (eds). Manual of Clinical Microbiology. 10th ed. Washington DC: ASM Pres, 2011:308-31.
  • Referans2. Kluytmans J, van Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev. 1997;10:505–20.
  • Referans3. Carroll KC. Rapid diagnostics for methicillin-resistant Staphylococcus aureus: current status. Mol Diagn Ther. 2008;12:15-24.
  • Referans4. Appelbaum PC. Microbiology of antibiotic resistance in Staphylococcus aureus. Clin Infect Dis. 2007;45(Suppl. 3):S165-S170.
  • Referans5. Naimi TS, LeDell KH, Como-Sabetti K, Borchardt SM, Boxrud DJ, Etienne J, et al. Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA. 2003;290:2976–84.
  • Referans6. Crawford SE, David MZ, Glikman D, King KJ, Boyle-Vavra S, Daum RS. Clinical importance of purulence in methicillin-resistant Stapylococcus aureus skin and soft tissue infections. J Am Board Fam Med. 2009;22:647-54.
  • Referans7. Dulon M, Peters C, Schablon A, Nienhaus A. MRSA carriage among healthcare workers in non-outbreak settings in Europe and the United States: a systematic review. BMC Infect Dis. 2014;14:363.
  • Referans8. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 8, 2018. http://www.eucast.org.
  • Referans9. Guclu E, Yavuz T, Tokmak A, Behcet M, Karali E, Ozturk O, et al. Nasal carriage of pathogenic bacteria in medical students: effects of clinic exposure on prevalence and antibiotic susceptibility. Eur Arch Otorhinolaryngol. 2007;264:85–8.
  • Referans10. Dağı HT, Fındık D, Demirel G, Arslan U. Detection of methicillin resistance and various virulence factors in Staphylococcus aureus strains isolated from nasal carriers. Balkan med j. 2015;32:171-5.
  • Referans11. Al-Tamimi M, Himsawi N, Abu-Raideh J, Al-jawaldeh H, Mahmoud SAH, Hijjawi N, et al. Nasal colonization by methicillin-sensitive and methicillin-resistant Staphylococcus aureus among medical students. J Infect Dev Ctries. 2018;12:326-35.
  • Referans12. Chen BJ, Xie XY, Ni LJ, Dai XL, Lu Y, Wu XQ, et al. Factors associated with Staphylococcus aureus nasal carriage and molecular characteristics among the general population at a Medical College Campus in Guangzhou, South China. Ann Clin Microbiol Antimicrob. 2017;16:28.
  • Referans13. Budri PE, Shore AC, Coleman DC, Kinnevey PM, Humpreys H, Fitzgerald-Hughes D. Observational cross-sectional study of nasal staphylococcal species of medical students of diverse geographical origin, prior to healthcare exposure: prevalence of SCCmec, fusC, fusB and the arginine catabolite mobile element (ACME) in the absence of selective antibiotic pressure. BMJ open. 2018;8(4):e020391.
  • Referans14. Treesirichod A, Hantagool S, Prommalikit O. Nasal carriage and antimicrobial susceptibility of Staphylococcus aureus among medical students at the HRH Princess Maha Chakri Sirindhorn Medical Center, Thailand: a follow-up study. J Infect Public Health. 2014;7:205-9.
  • Referans15. Ahmadi S, Desa MNM. Staphylococcus aureus nasal carriers among medical students in a medical school. Med J Malaysia. 2012;67:636-8.
  • Referans16. Bettin A, Causil C, Reyes N. Molecular identification and antimicrobial susceptibility of Staphylococcus aureus nasal isolates from medical students in Cartagena, Colombia. Braz J Infect Dis. 2012;16;329-34.
  • Referans17. Ansari S, Gautam R, Shrestha S, Ansari SR, Subedi SN, Chhetri MR. Risk factors assessment for nasal colonization of Staphylococcus aureus and its methicillin resistant strains among pre-clinical medical students of Nepal. BMC Res Notes. 2016;9: 214.
  • Referans18. Abroo S, Jazani NH, Sharifi Y. Methicillin-resistant Staphylococcus aureus nasal carriage between healthy students of medical and nonmedical universities. Am J Infect Control. 2017;45:709-12.
  • Referans19. Bischoff WE, Wallis ML, Tucker KB, Reboussin BA, Sherertz RJ. Staphylococcus aureus nasal carriage in a student community prevalence, clonal relationships, and risk factors. Infect Control Hosp Epidemiol. 2004;25:485-91.
  • Referans20. Chen CS, Chen CY, Huang YC. Nasal carriage rate and molecular epidemiology of methicillin-resistant Staphylococcus aureus among medical students at a Taiwanese university. Int J Infect Dis. 2012;16:e799-803.
  • Referans21. Doebbeling B, Reagan D, Pfaller M, Houston AK, Hollis RJ, Wenzel RP. Long-term efficacy of intranasal mupirocin ointment. A prospective cohort study of Staphylococcus aureus carriage. Arch Intern Med. 1994;154:1505–8.
  • Referans22. Kalmeijer MD, Coertjens H, van Nieuwland-Bollen PM, Bogaers-Hofman GA, De Baere A, Stuurman A, et al. Surgical site infections in orthopedic surgery: the effect of mupirocin nasal ointment in a double-blind, randomized, placebo-controlled study. Clin Infect Dis. 2002;35:353–8.
  • Referans23. Gualdoni GA, Lingscheid T, Tobudic S, Burgmann H. Low nasal carriage of drug-resistant bacteria among medical students in Vienna. GMS Krankenhhyg Interdiszip. 2012;7.
  • Referans24. Cirković I, Djukić S, Vuković D, Stevanović G, Svabić-Vlahović M, Stepanović S. Nasal carriage of methicillin-resistant Staphylococcus aureus among medical students of Belgrade University. Srp Arh Celok Lek. 2013;141:349-53.
  • Referans25. Okamo B, Moremi N, Seni J, Mirambo MM, Kidenya BR, Mshana SE. Prevalence and antimicrobial susceptibility profiles of Staphylococcus aureus nasal carriage among pre-clinical and clinical medical students in a Tanzanian University. BMC Res Notes. 2016;9:47.
  • Referans26. Sarkar A, Raji A, Garaween G, Soge O, Rey-Ladino J, Al-Kattan W, et al. Antimicrobial resistance and virulence markers in methicillin sensitive Staphylococcus aureus isolates associated with nasal colonization. Microb pathog. 2016;93:8-12.
  • Referans27. Orlin I, Rokney A, Onn A, Glikman D, Peretz A. Hospital clones of methicillin-resistant Staphylococcus aureus are carried by medical students even before healthcare exposure. Antimicrob Resist Infect Control. 2017;6:15.
There are 27 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Basic Science Research Articles
Authors

Fikriye Milletli Sezgin 0000-0002-8317-2312

Sevgi Sarıhan 0000-0003-1614-5813

Havva Nur Türkoğlu 0000-0003-1443-6094

Melihcan Yağmur 0000-0001-6425-3523

Gülgüşa Bucak 0000-0001-5521-5349

Nida Şvval Büyüktatar 0000-0003-1073-633X

Semih Mert Şener 0000-0002-9385-6777

Sıla Nur Şehnaz 0000-0002-2719-9342

Naime Meriç Konar 0000-0002-6593-7617

Mustafa Kasım Karahocagil 0000-0002-5171-7306

Project Number TIP.A4.19.008
Publication Date October 27, 2020
Acceptance Date August 18, 2020
Published in Issue Year 2020Volume: 42 Issue: 3

Cite

AMA Milletli Sezgin F, Sarıhan S, Türkoğlu HN, Yağmur M, Bucak G, Büyüktatar NŞ, Şener SM, Şehnaz SN, Konar NM, Karahocagil MK. Nasal Carriage of Staphylococcus aureus by medical students: assessment of antibiotic susceptibility and risk factors. CMJ. October 2020;42(3):259-270. doi:10.7197/cmj.vi.645617