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All Journal Journal of Clinical Microbiology and Infectious Diseases
Ni Nengah Dwi Fatmawati
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Immunology & microbiology

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Identification of Methicillin-Resistant Staphylococcus aureus (MRSA) carriers in the nasal passages of healthcare workers at Universitas Udayana Hospital Winaya, Made Illene; Made Agus Hendrayana; Ni Nyoman Sri Budayanti; Ni Nengah Dwi Fatmawati
Journal of Clinical Microbiology and Infectious Diseases Vol. 5 No. 1 (2025): Available online : 1 June 2025
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v5i1.82

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen responsible for healthcare-associated infections (HAIs), with growing global concern due to its resistance to multiple antibiotics, including beta-lactams. Healthcare workers (HCWs), particularly those in critical care settings, are at risk of being asymptomatic carriers, facilitating MRSA transmission. This study aimed to determine the prevalence and distribution of MRSA carriers among healthcare workers (HCWs) at Universitas Udayana Hospital, Bali, Indonesia. Methods: A descriptive cross-sectional study was conducted from October to November 2024. A total of 44 nasal swab samples were collected from nurses across various hospital wards. Samples were cultured on Mannitol Salt Agar and underwent Gram staining, catalase, and coagulase testing. MRSA identification was confirmed using the cefoxitin disk diffusion method, with inhibition zones of ≤21 mm indicating methicillin resistance, as per CLSI guidelines. Data were analyzed descriptively. Results: MRSA colonization was identified in 4 out of 44 samples (9.1%), with cases distributed in the NICU (2 cases), ICU (1 case), and Surgical Ward (1 case). In addition, 12 samples (27.3%) were positive for methicillin-sensitive Staphylococcus aureus (MSSA), while 28 samples (63.6%) contained coagulase-negative staphylococci (CNS), predominantly in the outpatient and emergency departments. Conclusion: The presence of MRSA among HCWs, especially in critical units like NICU and ICU, emphasizes the importance of enhanced infection control measures. Routine screening, strict adherence to hand hygiene, appropriate use of personal protective equipment, and implementation of decolonization protocols, such as mupirocin application and chlorhexidine bathing, should be optimized to reduce MRSA transmission risks within healthcare facilities.
Prevalence and antibiotic sensitivity patterns of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in pneumonia patients at Ngoerah Hospital from 2020 to 2022 Arikandini, Dewa Ayu Putu Aisaka Rajeshi; Ni Nyoman Sri Budayanti; Ni Nengah Dwi Fatmawati; I Putu Bayu Mayura
Journal of Clinical Microbiology and Infectious Diseases Vol. 5 No. 1 (2025): Available online : 1 June 2025
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v5i1.86

Abstract

Background: Pneumonia remains a major global cause of mortality, with Klebsiella pneumoniae recognized as a significant pathogen. The emergence of antibiotic resistance, particularly due to Extended-Spectrum Beta-Lactamase (ESBL) production by K. pneumoniae, complicates treatment efforts. This study aimed to determine the prevalence of ESBL-producing K. pneumoniae in pneumonia patients and assess its antibiotic sensitivity profile. Methods: A descriptive cross-sectional study was conducted retrospectively using secondary data from VITEK 2 Compact (bioMérieux) laboratory results on sputum samples collected from pneumonia patients at Ngoerah Hospital from 2020 to 2022. A total of 515 samples met the inclusion criteria out of 1,350 tested. Results: ESBL-producing K. pneumoniae was identified in 305 isolates (59.2%), with yearly prevalence rates of 63% in 2020, 52% in 2021, and 61% in 2022. Most patients were male (66.6%), aged 60 years or older (40%), and treated in non-ICU settings (69.2%), with expectorated sputum as the most common specimen type (63%). Antibiotic sensitivity testing revealed high susceptibility of ESBL-producing isolates to ertapenem (100%), meropenem (100%), amikacin (93%), and tigecycline (81%). Conclusion: ESBL-producing K. pneumoniae accounted for over half of pneumonia cases, with fluctuating prevalence across the study period. The infection predominantly affected older male patients treated in non-ICU wards. Despite resistance to many beta-lactam antibiotics, high sensitivity to carbapenems and other specific agents highlights their continued relevance in treatment. Surveillance of antibiotic resistance patterns remains essential for effective clinical management.
Co-Authors Arikandini, Dewa Ayu Putu Aisaka Rajeshi I Putu Bayu Mayura Made Agus Hendrayana Ni Nyoman Sri Budayanti Winaya, Made Illene