Evaluation of Prevalence of MRSA Colonization in 150 Neonates in two  Medical Centers in Iran.

Professor M.H. Soltanzadeh MD
Professor of Pediatrics, ID ,
Shahid Beheshti University of Medical Science ,
Tehran ,IRAN

Dr  A. H. Arbabi,MD Assistant prof.of Iran University ,Tehran, Iran.

Dr F. Shirvani , MD, ID ,Assistant Prof.of Pediatrics Shahid Beheshti University , Tehran ,Iran

Dr K. Mirnia, MD,Resident .of Pediatrics, Shahid Beheshti University,Tehran, Iran.

Dr. M. Radfar, MD, Assistant Prof. Of Pediatrics .Neonatologist,Shahid Beheshti University,Tehran, Iran.

Dr. M. Khodami , MD , Associate of Pathology ,Shhid Beheshti University,Tehran, Iran.

M. Gharouni .Microbiologist,Shahid Beheshti University,Tehran,Iran.                                                                                                      


Background  : Penicillin was introduced for s- aureus treatment in 1940. However with the over usage this antibiotic, S- aureus has become increasingly Antibiotic Resistant .

Due to this problem we studied  the epidemiological prevalence of MRSA colonization on 150 Neonates in two Medical Centers, Imam Hossein  and Shahid Akbarabadi in 2002-2003 .

Methods  :  Skin and Umbilical samples obtained from 150 newborns in two Medical Centers after  72 hours of admission. Also samples were obtained from anterior nasal mucosa of personnel involved with Neonates in that department  by sterile cotton swap .

Sterile swap was inoculated  in to nutrient agar then within 24 h was transferred to sheep blood agar. Colonies  that were gram positive in smear and were coagulase  positive and DNAase positive were known as s-aureus . s-aureus were transformed to mulleur hinton NaCl  4 % culture that had Oxacillin Disk.

After 24 h of incubation at 37° C , colonies that grew <13 mm around the Disk were known  as  MRSA , and colonies that grew  > 13 mm were known as MSSA .

Information related to neonates and personnel were collected by completing a questionnaire. All the data were analyzed  by statistical software SPSS-11.

In our study, 47/3 % of neonates were Male and 52/7 % were female . Prevalence of MRSA in male was 52/8 % and in female 47/2 %. Mean weight of newborns were 2394 grams +/- 1119 grams.

61 % of S- aureus were Resistant to Oxacillin. Prevalence of MRSA in Imam Hossain Hospital was 96/6 % and in Shahid Akbarabadi was 26/7 %  that this  difference  was statistically  significant  P < 0.0001. All  MRSA were sensitive  to Vancomycin in Imam Hossain Hospital. Difference of  MRSA S-resistant  to Cloxacillin and Clindamycin were statistically  significant  P <0.0001.

In Akbarabadi Hospital difference of MRSA S-Resistant to Cloxacillin. Clindamycin and Penicillin were not statistically significant.

Hospital and Mothers were the most effective agent in  MRSA  S Prevalence.

Imam  Hossein is a general Hospital  including an adult Surgical Ward but Shahid Akbarabadi Hospital is a Delivery Center that has an active  NICU . Prevalence of  MRSA in Imam Hossein Hospital is greater than Shahid Akbarabadi Hospital due to more variety of patients and over usage Antibiotics. MRSA colonies resistant to Cloxacillin , Clindamycin and Penicillin are more in Immam Hossain Hospital and therefore these antibiotics are not used. This Resistance is fewer in Shahid Akbarabadi Hospital and therefore these Antibiotics are still used. 

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