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NASAL CARRIAGE OF STAPHYLOCOCCUS AUREUS AMONG HEALTHCARE WORKERS AND FOOD HANDLERS
Staphylococcus is a Gram-positive coccoid bacterium that is microscopically observed as individual organism in irregular grape-like clusters (Rayan et al., 2004). The term Staphylococcus is derived from the Greek term “staphyle”, meaning a bunch of grapes. This appearance is due to their cell division in multiple planes. The genus is made up of at least 40 species. Most are non pathogenic residing as normal flora on the skin and mucous membranes of humans and other organisms while some species are pathogenic (Tolan, et al; 2008 and Willey et al. 2008).
According to Willey et al. (2008), carrier status is a state where an infected person is a potential source of an infection for others, otherwise known as a “an asymptomatic carrier”. Staphylococcus aureus (S. aureus) has become one of the major public health problems because of its ubiquitous nature, pathogenicity and drug resistivity (Skwan-nska, et al., 2009). Staphylococcus aureus can be toxigenic and invasive, Vasconceles, et al., (2010) and possesses the unique resistance ability against beta-lactam antibiotics of which methicillin is the most resistant. According to the data of World Health organization WHO (2007) up to 30% of the population in developed countries suffer from food borne diseases caused by S. aureus each year.
Literature reveals that environmental, occupational and dietary factors are implicated in the spread of S. aureus. Dirty environment especially the solid waste dumpsite provide breeding sites and hence exacerbated the air- borne infections caused by S. aureus as well as fungal spores (Onyemelukwe, et al., 2014). Waste collectors and disposers, hospital workers, formites and food vendors are also implicated as vehicles for the spread of the organism across the wider public.
The ecological niches of S. aureus strains are the anterior nares Peacock, et al., (2003), thus houses this bacterium that has been long recognized as the major cause of nocosomial and community acquired infections (von Eiff, et al., 2010, Guido, et al., 2012).Also some other authorities identified the anterior nares as the most persistent site for staphylococci colonization (Kuehert, et al., 2006).
Nasal carriage is the harbouring of infectious disease in the nose by assymptomatic individuals. Some people carry S. aureus in their nose without nasal symptoms thus healthy individuals have small risk of contracting an infection caused by S. aureus but they can be carriers of the organism (Casewell, 1998). In health care settings, about 30% of the workers and patients may carry S. aureus in their nose and other body parts of the body (CDC 2010). According to data of World Health Organization, WHO ( 2007), up to 30% of the population in developed countries suffer from vomiting and diarrihaeral-like infection as a result of food borne diseases caused by S. aureus each year. These symptoms from food borne disease were due to the toxins produced by S.aureus (Argudan, et al; 2010). Among the 22 different enterotoxins, five (A, B, C, D & E) are known to be responsible for 95% of staphylococcal food poison cases (Jay, et al., 2005). In a work done by Onyemelukwe, et al.,( 1992), at the University of Nigerian Teaching Hospital Enugu on Nasal carriage of S. aureus, it was reported that the nasal carriage of S.aureus had a 34.4% carriage rate. Studies worldwide have shown that nasal carriage of S. aureus by both healthcare workers and food handlers is a big public health hazard for both methicillin resistance and non methicillin resistance S. aureus, Mainus et al., (2006), Yasson, et al., (2013), Habeeb et al., (2014), and also in the carriage of enterotoxigenic S.aureus among food handlers.
Several studies have reported that the rate of the nasal carriage of Staphylococcus aureus among the HCWs ranges from 16.8% – 56.1% (Dan et al., 1992). This and other similar studies have shown that S. aureus infections can be transmitted through the food handlers and healthcare workers in some cases resulting to food borne diseases and nocosomial infections. In the verge of these instances, S. aureus had been shown to be asymptomatic in these people, hence this work was embarked upon with the following objectives.
AIM AND OBJECTIVES
To determine Staphylococcus aureus nasal carriage rate of asymptomatic food handlers and healthcare workers in Enugu Metropolis.
- To identify methicillin resistant strains amongst the aureus isolates
- To detect types and combinations of enterotoxins produced by the aureus isolates from food handlers.
- To monitor the effect of length of employment, age, profession, education level, hand washing habit and job description on aureus nasal colonization.