Methicillin-resistant Staphylococcus aureus Decolonization in Healthcare Workers and Effect on Hospital Infection Rate

Abstract

Introduction
Staphylococcus aureus is one of the most common cause of nosocomial and health care associated infections. Rise in the frequency of methicillin-resistant Staphylococcus aureus (MRSA) strains in last few years possess a great challenge in management of complicated infections due to availability of few and expensive therapeutic options and increasing antimicrobial resistance. The incidence of MRSA infections is thought to have increased from 35% to around 51% in the last decade only¹ and currently a prevalence of more than 60% is reported across the country.² The primary infection control procedure for limiting the nosocomial spread of MRSA, as recommended by the Centre of disease control and prevention (CDC), USA is practicing contact precautions (separation of patients through placing infected/ colonized patients in single rooms or cohorting together, use of gown and gloves for all contact with the patient or their environment, and use of dedicated patient-care equipment).³ Another strategy employed by some healthcare institutes is performing admission screening cultures for MRSA and isolating the colonized patients, using barrier precautions, and in some hospitals also followed by MRSA decolonization by different regimens including chlorhexidine baths, 2% intranasal mupirocin application of intranasal povidone-iodine and washing with povidone-iodine soap. On the other hand, colonization of HCWs is a commonly overlooked cause of nosocomial spread of
MRSA. HCWs, when not screened, due to unknown colonization status, are not aware and cognizant to follow contact precautions while interacting with the patients and may lead to nosocomial spread of MRSA. MRSA screening and subsequent decolonization of HCWs is an effective yet debated method followed by many hospitals as a MRSA controlling tactic. Many studies have evaluated different decolonization regimens used in colonized/ infected patients, and their effect on hospital MRSA infection rates. However only few studies have assessed the impact of screening and decolonization of HCWs on inhospital MRSA infections. In this study, we report the result of HCWs screening and decolonization for MRSA and its influence on hospital MRSA infection rate.