Nasal colonization by <i>Staphylococcus sp</i>. in inpatients

Nasal sample collection, antimicrobial susceptibility tests, and analysis of medical records of inpatients (n=71) were performed, and a questionnaire was applied. Data were analyzed by descriptive and inferential statistics using the chi-square, Student’s t, and Mann-Whitney tests (α=5%).

Results

Nearly half (44.4%) of the patients who were significantly associated with prolonged antibiotic treatment (p=0.02) was infected with methicillin-resistant Staphylococcus sp.. A significant association was observed between patients with sensitive strains and absence of antibiotic treatment prior to sample collection (p=0.02) or absence of wounds (p=0.003).

Conclusion

Strains of methicillin-resistant Staphylococcus sp. were found, and there was no significant difference between the S. aureus species and the coagulase-negative Staphylococci groups, which indicates the degree of spread of methicillin resistance among different species of Staphylococcus.

Nursing service, hospital; Clinical nursing research; Nursing care; Nasal mucosa/microbiology; Staphylococcus; Nasopharynx/microbiology; Inpatients

Dependent variables	n(%)
Presence of nasal Staphylococcus sp
S. aureus	20(28.8)
Coagulase-negative Staphylococcus	43(60.6)
No growth of Staphylococcus or bacteria	8(11.3)
Behavior of Staphylococcus sp. relative to methicillin
Resistant	28(44.4)
Susceptible	35(55.6)
Behavior of S. aureus relative to methicillin
Resistant	7(9.9)
Susceptible	64(90.1)

Characteristics	Susceptibility to methicillin					Staphylococcus sp
	Resistant	No resistant				S. aureus	CoNS
	n(%)	n(%)	PR	95%CI	p-value	n(%)	n(%)	PR	95%CI	p-value
Gender
Male	13(44.8)	16(55.2)				11(37.9)	18(62.1)			0.33
Female	15(44.1)	19(55.9)	1.02	0.58-1.77	0.95	9(26.5)	25(73.5)	1.43	0.69-2.97	0.33
Use of antibiotics prior to sample collection
Yes	20(57.1)	15(42.9)				10(28.6)	25(71.4)			0.54
No	8(28.6)	20(71.4)	2.00	1.04-3.84	0.02	10(35.7)	18(64.3)	0.80	0.39-1.65	0.54
Hospitalization in the last year
Yes	15(45.5)	18(54.5)				9(27.3)	24(72.7)			0.42
No	13(43.3)	17(56.7)	1.05	0.60-1.83	0.87	11(36.7)	19(63.3)	0.74	0.36-1.54	0.42
Presence of wound
Yes	25(56.8)	19(43.2)				13(29.5)	31(70.5)			0.57
No	3(15.8)	16(84.2)	3.60	1.23-10.49	0.003	7(36.8)	12(63.2)	0.80	0.38-1.69	0.57
City
Caicó	14(37.8)	23(62.2)				13(35.1)	24(64.9)			0.49
Other city	14(53.8)	12(46.2)	0.70	0.41-1.21	0.21	7(26.9)	19(73.1)	1.30	0.60-2.82	0.49
Systemic impairment
Yes	25(49.0)	26(51.0)				14(27.5)	37(72.5)			0.17
No	3(25.0)	9(75.0)	1.96	0. 71-5.43	0.13	6(50.0)	6(50.0)	0.55	0.27-1.13	0.17
Clinic
ICU	4(40.0)	6(60.0)	1			3(13.0)	7(70.0)	1
Medical	19(51.4)	18(48.6)	0.78	0.34-1.77		13(35.1)	24(64.9)	0.85	0.30-2.42	0.76
Surgical	5(31.3)	11(68.8)	1.28	0.45-3.66	0.38	4(25.0)	12(75.0)	1.20	0.34-4.28	0.76
Diabetes
Yes	17(51.5)	16(48.5)				9(27.3)	24(72.7)			0.42
No	11(36.7)	19(63.3)	1.40	0.79-2.50	0.24	11(36.7)	19(63.3)	0.74	0.36-1.54	0.42
Cardiovascular disorders
Yes	8(33.3)	16(66.7)				6(25.0)	18(75.0)			0.37
No	20(51.3)	19(48.7)	0.65	0.34-1.24	0.16	14(35.9)	25(64.1)	0.70	0.31-1.56	0.37
Cancer
Yes	4(66.7)	2(33.3)				3(50.0)	3(50.0)			0.37
No	24(42.1)	33(57.9)	1.583	0.83-3.01	0.39	17(29.8)	40(70.2)	1.68	0.69-4.10	0.37

Dependent variables	Quantitative independent variables
	Age		Nº days with antibiotic prior to collection		Nº days hospitalized in a hospital		Nº hospitalizations in the last year
	Mean (standard deviation)	p-value	Median (quartile 25-quartile 75)	p-value	Median (quartile 25-quartile 75)	p-value	Median (quartile 25-quartile 75)	p-value
Staphylococcus sp. resistance to methicillin
MRSA	65.7(19.5)	0.48	3.5(0.2-9.7)	0.02	5.4(3.0-11.2)	0.05	1(0.0-1.7)	0.89
MSSA	61.8(23.0)	0.48	0(0.0-3.5)	0.02	3(2.0-5.4)	0.05	1(0.0-1.0)	0.89
Staphylococcus sp
S. aureus	59.5(24.1)	0.31	0.5(0.0-3.0)	0.15	3(2.2-5.4)	0.20	1(0.0-1.0)	0.57
CoNS	65.4(20.1)	0.31	2.0(0.0-9.0)	0.15	5.4(2.0-10.0)	0.20	1(0.0-2.0)	0.57

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author Gilmara Celli Maia de Almeida Rua André Sales, 667, Campus Caicó, Caicó, RN, Brazil. Zip Code: 59300-000 gilmaracelli@yahoo.com.br