Staphylococcal nasal colonisation amongst medical students: Importance of imparting knowledge about infection control practices during undergraduates training

M. Gupta, G. Sinha, Ashutosh Kumar Singh, P. Prakash
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Abstract

Background: Staphylococcus aureus is a common cause of hospital-acquired infections. Medical undergraduates are frequently exposed to hospital-adapted bacterial strains especially S. aureus and therefore are always at risk of colonisation. Materials and Methods: A prospective study was conducted on 150 undergraduate students, of different semesters, to detect S. aureus nasal colonisation. A detailed history regarding attending the hospital ward teaching, hospitalisation, frequency of nose touching and immunocompromised condition was unequivocally obtained from all the participants. Anterior nares were swabbed and inoculated on mannitol salt and blood agar plates. S. aureus isolates were subsequently verified by conventional microbiological techniques. The antibiotic susceptibility testing was done by the modified Kirby–Bauer disc diffusion method. In addition, PCR-based detection of mecA gene and pvl gene was performed. Results: Out of 150 students, we found 18 students (3 of 1st, 10 of 5th and 5 of 9th semester, respectively) to be colonised by S. aureus. Of these 18 isolates, 8 were found to be methicillin-resistant. We observed a significant association (P < 0.05) of hospital exposure, ward teaching/hospitalisation with S. aureus colonisation. These S. aureus isolates exhibited varying susceptibility towards different antibiotics with multiple antibiotic resistance indexes ranging from 0.08 to 0.58. Interestingly, all eight methicillin-resistant S. aureus isolates displayed mecA positivity while all were found to be pvl negative. Conclusion: The results indicate the importance of imparting knowledge about infection control practices during the initial years of undergraduate training in medical schools, which may increase awareness amongst students before getting outpatient or ward postings.
医学生中葡萄球菌鼻腔定植:在本科生培训中传授感染控制知识的重要性
背景:金黄色葡萄球菌是医院获得性感染的常见原因。医学本科生经常暴露于医院适应的细菌菌株,特别是金黄色葡萄球菌,因此总是有定植的风险。材料与方法:对150名不同学期的本科生进行了一项前瞻性研究,检测金黄色葡萄球菌鼻腔定植。明确地从所有参与者那里获得了关于参加医院病房教学、住院、触摸鼻子频率和免疫功能低下状况的详细历史。拭子擦拭鼻腔,接种于甘露醇盐和血琼脂板上。随后用常规微生物学技术对金黄色葡萄球菌分离株进行了验证。药敏试验采用改良Kirby-Bauer圆盘扩散法。此外,pcr检测了mecA基因和pvl基因。结果:在150名学生中,有18名学生(第一学期3名,第五学期10名,第九学期5名)被金黄色葡萄球菌定植。在这18株分离株中,发现8株对甲氧西林耐药。我们观察到医院暴露、病房教学/住院与金黄色葡萄球菌定植有显著相关性(P < 0.05)。这些金黄色葡萄球菌对不同抗生素的敏感性不同,多重耐药指数在0.08 ~ 0.58之间。有趣的是,所有8株耐甲氧西林金黄色葡萄球菌均显示mecA阳性,而所有菌株均为pvl阴性。结论:研究结果表明,在医学院校本科教育的最初几年,传授感染控制知识的重要性,这可以在学生进入门诊或病房工作之前提高他们的感染控制知识。
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