Surveillance of Methicillin Resistant Staphylococci in Patients and their Hospital Care Providing Relatives in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

Background Staphylococcal infections remain a problem the world over. Two important staphylococcal virulence and drug resistance factors are PVL and PbP2a. Constant surveillance for these factors can improve treatment outcomes and reduce cost and duration of hospitalization. Objectives The aim of this study was to carry out surveillance of methicillin resistant Staphylococci among patients and their hospital care-giving contacts, and to provide an update on susceptibility pattern of the local isolates to anti-staphylococcal antibiotics. Methods Skin and nasal specimens were collected from patients and their hospital caregivers and processed by standard microbiological and molecular techniques. Results Recovery rate of MRSA was 23% while MRCoNS was 5% (t = 9.1875; P = 0.00004661). Nine (18%) of S. aureus isolates were SpA– strains, while 1 (2%) was OS-MRSA. Of 35 MRSA isolates, 16 (53%) possessed PbP2a protein. Three of the PbP2a+ MRSA and 4 of MSSA isolates were VISA strains. Thirteen (43%) of isolates tested had Oxacillin MIC >256µg/ml, while all (40 or 100%) were susceptible to Teicoplanin (MIC range = 0.06-4µg/ml). Of 25 S. aureus isolates tested for PVL gene, 6 harbored the gene; majority (67%) of the pv gene – bearing S. aureus were of MSSA phenotypes. Conclusion Teicoplanin appears to be the drug of choice for empirical treatment of methicillin-resistant Staphylococcal infections in our locality. A report of SpA– S. aureus and OS-MRSA isolates are being made for the first time in this region and raises the need to include PBP2a detection among routine laboratory tests on Staphylococcal isolates.