Abstract
BackgroundStaphylococcus aureus is one of the major pathogens of public health importance responsible for various forms of infection. Development of resistance to commonly used antimicrobials limited treatment options against infections due to this pathogen. Antimicrobial resistance profile of Staphylococcus aureus isolated from patients with surgical site infection and ear infection and corresponding nasal swab was investigated in Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia.MethodsWound and corresponding nasal swabs from patients with surgical site infection from general surgery ward (n = 14), orthopedic ward (n = 21) and those with otitis media (n = 59) from Ear Nose and Throat (ENT) ward were cultured for S. aureus isolation according to standard procedures from December 2013 to June 2014. Isolates were investigated for susceptibility to panel of 17 antimicrobials using Kirby Bauer disc diffusion assay. Susceptibility to methicillin was phenotypically determined based on sensitivity of isolates to cefoxitin and oxacillin.ResultsA total of 79 S. aureus isolates were recovered from 54(57.4%) of patients. The isolates were resistant to ampicillin (100%), oxacillin and cefoxitin (68.4%, each), clindamycin (63.3%), cephalothin (59.5%), tetracycline (57%), sulfamethoxazole + trimethoprim and bacitracin (53.2%, each), and erythromycin (51.9%). Resistance to two or more antimicrobials was recorded in 74 (95%) of the isolates, while resistance to 3 or more antimicrobials was detected in 65(82.3%) of the isolates. Fifty-four (68.4%) of the isolates were methicillin resistant S. aureus (MRSA). Rate of occurrence of MRSA was more common among isolates from surgical wards (p < 0.001) compared to those from ENT ward. High level of multi-drug resistance (MDR) was detected more commonly among isolates from orthopedic ward than those from general surgical ward and patients with ear infection (p < 0.001). One of the isolate cultured from wound swab of a patient with surgical site infection from orthopedic ward was resistant to all of the 17 antimicrobials tested.ConclusionS. aureus isolates from patients in TASH exhibited resistance to majority of antimicrobials commonly employed for the treatment of staphylococcal infections which calls for urgent need of prudent use of antimicrobials and the need for implementation of effective infection control practices to hamper spread of MDR S. aureus.
Highlights
Staphylococcus aureus is one of the major pathogens of public health importance responsible for various forms of infection
Rate of recovery of S. aureus was higher among specimens obtained from patients with otitis media (44.1% from ear discharge and 50.9% from nasal swab) compared to wound and nasal swab of patients with surgical site infection which ranged from 28 to 38%
Antimicrobial resistance profile of S. aureus All S. aureus isolates examined in the current study were resistant to at least one of the 17 antimicrobials
Summary
Staphylococcus aureus is one of the major pathogens of public health importance responsible for various forms of infection. Antimicrobial resistance profile of Staphylococcus aureus isolated from patients with surgical site infection and ear infection and corresponding nasal swab was investigated in Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Staphylococcus aureus is a normal flora associated with skin, skin glands and mucous membrane of almost all warm blooded animals and about 30% of the human population is colonized by S. aureus [1]. It is a leading cause of life- threatening blood stream infection, osteoarticular, skin, soft tissue, respiratory tract, deviceassociated and surgical site infections in immunocompromised, young and elderly patients [2]. S. aureus was the most frequently isolated pathogen among patients with otitis media at Bahir Dar, northwest Ethiopia [7], Ayder teaching and Referral Hospital, Mekelle, northern Ethiopia [8] and isolates were resistant to several antimicrobials
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