Abstract
Objective To determine the clinical implication of and intestinal carriage with methicillin resistant Staphylococcus aureus (MRSA) and extended spectrum beta-lactamase (ESBL) -producing Enterobacteriacae. Methods : A total of 180 stool specimens were screened for MRSA and ESBL-producing enterobacteria. Identification of ESBL- producing Enterobacteriacae was done by MicroScan Walk Away 96 system (Dade Behring Inc., West Sacramento, CA 95691, USA) and confirmation by double-disc synergy test. MRSA was identified by disc diffusion using 30 mu g cefoxitin diSc and the MicroScan. Results The rate of fecal MRSA carriage was 7.8% (14/180), 35.7% (5/14) were recovered from surgical wards. Three patients (21.4%) had MRSA recovered from other body sites, and 2 (14.2%) had in addition ESBL -producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) respectively. Four (28.5%) patients with MRSA fecal carriage died. MRSA fecal carriage was recovered from both inpatients and outpatients. Four (2.2%) cases carried ESBL-producing Enterobacteriacae in feces. Three (75%) were from intensive care unit (ICU). One patient had both ESBL-producing E. coli and K. pneumoniae from stool as well as E. coli from tracheal aspirate. Two ICU patients with fecal ESBL died. Conclusion; Fecal screening for MRSA and ESBL of all patients at high risk admitted to different hospital wards and ICUs and implementing infection control measures were recommended.