Uncovering the silent public health threat: nasal carriers of linezolid-resistant, vancomycin-intermediate and mupirocin-resistant MRSA among healthcare workers in a tertiary care hospital in Central India.

Introduction: Healthcare-associated infections caused by multidrug-resistant (MDR) Staphylococcus strains pose a significant challenge. Healthcare workers (HCWs) are potential vectors in transmitting these strains. This study assessed the prevalence of nasal carriage of staphylococci among HCWs.

Methods: This prospective cohort study was conducted from March to June 2024 at a tertiary care hospital in Central India. Nasal swabs from 178 HCWs were collected and screened for methicillin-sensitive S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), methicillin-sensitive coagulase-negative staphylococci (MS-CONS), and methicillin-resistant CONS (MR-CONS) using standard microbiological methods. Antimicrobial susceptibility and biofilm production were evaluated.

Results: Of 178 HCWs, 61.8% were Staphylococcus carriers, including 36% MRSA. High MRSA carriage was observed in junior residents, interns, and nursing assistants, particularly in the surgical department. Furthermore, the notifiable carriage rate was observed among HCWs who did not consistently adhere to hand-washing practices and/or frequently picked their noses, and those regularly involved in patients' wound care. All MRSA and MR-CONS were MDR, while 30% of MSSA and 45.5% of MS-CONS were MDR. No vancomycin resistance was detected, but 12.5% of MRSA showed intermediate resistance to vancomycin (VISA). Linezolid resistance was observed in 10% and 37.5% of MRSA (LRSA) and CONS, respectively. Biofilm production was noted in 72.7% of isolates.

Conclusion: The high prevalence of nasal carriers of MRSA and MDR staphylococci strains and the emergence of VISA and linezolid-resistant staphylococci underscores the need for stringent infection control and antimicrobial stewardship measures in healthcare settings. Regular screening and decolonization protocols for HCWs are critical in preventing the spread of resistant pathogens.