Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a major hospital acquired pathogen. In Cameroon, there is limited data on nasal carriage of MRSA and its antibiotic susceptibility testing and risk factors for multi resistance to antibiotics in hospitalized patients and medical staff . A prospective, qualitative, cross-sectional hospital-based study was carried out. Anterior nasal swabs were taken from 579 participants and bacterial strains were identified by conventional method and antibiotic susceptibility testing. Methicillin resistance was confirmed with cefoxitin and oxacillin disks. Of the 579 samples analysed, 53.0% were positive for S. aureus, 45.4% were MRSA. MRSA constituted 85.7% of all the S. aureus identified. The prevalence of MRSA in nasal carriage was significantly higher in females (49.6%) than in males (34.0%). The overall prevalence of MRSA in nasal carriage in both medical staff and hospitalized patients was 45.4%. The prevalence of MRSA in nasal carriage was significantly higher in RHL (49.0%) and RHB (48.5%) compared to the UTHY (36.3%). The prevalence of MRSA in nasal carriage was significantly higher in the surgical ward (59.7%) and paediatric ward (45.2%) compared to the other units. Among the MRSA isolates, the maximum sensitivity was observed with vancomycin (97.0%) and minocycline (95.1%), while the least sensitivity was observed with penicillin (0.0%) and ampicillin (0.8%). Binary logistic regression model showed that being aged 35 years an above and being hospitalized for more than 15 days were strongly associated with MDR to MRSA. Nasal carriage of MRSA is increasing rapidly and call for urgent preventive measures. Key words: Healthcare personnel, adult patients, nasal carriage, antibiotic susceptibility, risk factors, health care personnel, adult, patients, multi drug resistance (MDR), methicillin-resistant Staphylococcus aureus (MRSA).
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) is any strain of S. aureus bacteria that has developed resistance to beta-lactam antibiotics which include the penicillins and the cephalosporins
The present study showed a prevalence of 45.4% (263/579) of nasal carriage of MRSA (Figure 1), which is within the MRSA prevalence range for Africa according to
A literature review assessing burden of MRSA in Africa which stated that the prevalence of MRSA was lower than 50% in most African countries (Falagas et al, 2013), prevalence obtained in this study is higher than a result obtain in a study conducted in three regions in Cameroon which revealed a prevalence rate of 34.6% (Gonsu et al, 2013), but lower than that of a multicenter study conducted in Eritrea that obtained a result of 72% (Garoy et al, 2019), and that of 53.4% obtained in a study in East Africa (Wangai et al, 2019)
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) is any strain of S. aureus bacteria that has developed resistance to beta-lactam antibiotics which include the penicillins (methicillin, dicloxacillin, nafcillin, oxacillin.) and the cephalosporins. This results in infections that are more difficult to treat than ordinary Staphylococcal infections. MRSA is a bacterium responsible for several difficult-to-treat infections in humans. It may be called multidrug-resistant S. aureus or oxacillin-resistant S. aureus (ORSA). MRSA is a real burden in hospitals where patients with open wounds, invasive devices and weakened immune systems are at greater risk of infection than the general public. MRSA is a growing problem in shared facilities such as hospitals, healthcare facilities and nursing homes
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