#68 Prevalence of Staphylococcus aureus bacteremia at Saint Damien Hospital, Nos Petits Frères et Sœurs January 2020-June 2021, Haiti

Abstract

Abstract Background Nosocomial bacteremia is a healthcare-associated infection. It presents significant morbidity and mortality. Its prevention is based on the control of the risk factors, collection, and analysis of data to set up actions and measures aimed at educating staff, patients, and families to mitigate complications. Bacteremia is regularly monitored at Saint Damien Hospital (HSD);an increase in Staphylococcus aureus (SA) bacteremia was observed in January 2020. All SA infections were reviewed at St Damien during eighteen months to determine the prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-sensitive Staphylococcus aureus (MSSA) and the distribution by unit. Also, the frequency of nosocomial and community SA was determined. Nosocomial infections and those associated with SA remain a public health concern because of the antimicrobial resistance, the death rate, and the associated cost. Method A descriptive retrospective study was carried out over a period from January 2020 to June 2021 for all patients hospitalized in pediatrics who underwent a blood culture and whose results reported SA. Data were collected from microbiology laboratory registers and patient records. Results From January 2020 to June 2021, two thousand two hundred thirty-five (n = 2235) blood cultures were performed for a total of four thousand two hundred eighty-seven (n=4287) admissions. From these blood cultures performed, 11% of microorganisms (n=479) were isolated, of which 18.37% are SA (n=88). From these SA 68% were resistant to methicillin/MRSA (n=60), 32% sensitive to methicillin/MSSA (n=28).51% (n= 45) were associated with nosocomial infections (NI), 49% (n= 43) related to community infections. From the MRSA strains, 57% (n=34) are of nosocomial (NI) and 43% (n=26) are of community infection. These strains mainly came from emergency services 40% (n=24) followed by neonatology 22% (13) and intensive care 17% (10 ). The mortality rate for MRSA and MSSA were 32% (n=19) and 18% (n=5), respectively. 40% of MRSA isolates were multi-drug resistant (n=24). The resistance rate was 76% for penicillin (n=67) 65% for oxacillin (n=57) 35% for cefoxitin (n=31). Conclusion The frequency of isolation of Staphylococcus Aureus (SA) as well as the prevalence of SA and MRSA infections, was relatively high during this period. Its existence in a community setting and multidrug resistance to antibiotics is an alert making this bacteremia a public health priority to be monitored and brought under control.