Maladies infectieuses cliniques : accès libre

Prevalence of Methicillin Resistant Staphylococcus aureus and Assessment of Associated Factors among Patients Admitted at Jimma Medical Center, Southwest Ethiopia

Abstract

Esayas Tekle, Yonas Adisu, Zewdineh Sahlemariam, Yared Alemu, Sisay Teferi and Gemechu Tiruneh

Background: Methicillin Resistant Staphylococcus aureus (MRSA) is one of the most important hospital associated pathogens whose emergence has created clinical difficulties for nosocomial infections. The extent of nasal colonization during hospitalization, however, has not been investigated. Therefore, this study aimed to assess the prevalence and associated factors of methicillin resistant Staphylococcus aureus nasal colonization in inpatient wards at an Ethiopian teaching hospital offering tertiary care for the prevention and control of its transmission.

Methods: A hospital based prospective cross-sectional study was conducted among 388 admitted patients at Jimma medical center in Jimma town, southwest Ethiopia, from October 1 to December 30, 2020. Proportional stratification and systematic random sampling were employed to get a proportional number of participants and to recruit study participants from each ward. Socio-demographic data and data on associated factors were collected using a structured questionnaire. Two nasal swab samples were taken from each patient, the first within 48 hours of admission and the second at the time of discharge. The specimens were then inoculated on Mannitol salt agar and yellowish colonies were sub-cultured on nutrient agar. The isolate was further identified using gram reaction, catalase, and coagulase tests. The Cefoxitin disk was used for the detection of methicillin resistant Staphylococcus aureus. Multivariate logistic regression was employed for factors associated with Methicillin Resistant Staphylococcus aureus (MRSA) nasal colonization. A P-value <0.05 was defined as statistically significant for all results.

Results: The overall prevalence of MRSA nasal colonization was 29.9%. The prevalence of MRSA at the time of admission was 23.7%. From the total (116) MRSA isolated, 20.69% of patients were newly colonized. The isolates showed the highest resistance to penicillin (97.9%). History of hospitalization, chronic wound infection, and diabetes mellitus were significantly associated with MRSA nasal colonization.

Conclusion: The prevalence of MRSA was 29.9%. The isolated S. aureus showed the highest resistance to penicillin (97.9%) and the majority of the isolates were multidrug resistant. Having a history of hospitalization, chronic wound infection, and diabetes mellitus were significantly associated with MRSA nasal colonization. MRSA transmission in the hospital can be reduced by screening patients during their admission.