Abstract
BackgroundMRSA infections are becoming more prevalent throughout the HIV community. MRSA infections are a challenge to both physicians and patients due to limited choice of therapeutic options and increased cost of care.ObjectivesThis study was aimed to determine the prevalence of colonization and co-resistance patterns of MRSA species among HIV positive pediatric patients in the Amhara National Regional State, Northwest Ethiopia.MethodsCulture swabs were collected from the anterior nares, the skin and the perineum of 400 participants. In vitro antimicrobial susceptibility testing was done on Muller Hinton Agar by the Kirby-Bauer disk diffusion method, using 30 μg cefoxitin (OXOID, ENGLAND) according to the recommendations of the Clinical and Laboratory Standards Institute. Methicillin sensitivity/resistance was tested using cefoxitin. Data was analyzed by descriptive statistics and logistic regression model using Epi Info 7.Results S. aureus was detected in 206 participants (51.5%). The prevalence of MRSA colonization in this study was 16.8%. Colonization by S. aureus was associated with male gender (OR = 0.5869; 95% CI: 0.3812–0.9036; p-value = 0.0155), history of antibiotic use over the previous 3 months (OR = 2.3126; 95% CI: 1.0707–4.9948; p-value = 0.0329) and having CD4 T-cell counts of more than 350 x 106 cells / L (OR = 0.5739; 95% CI = 0.3343–0.9851; p-value = 0.0440). Colonization by MRSA was not associated with any one of the variables. Concomitant resistance of the MRSA to clindamycin, chloramphenicol, co-trimoxazole, ceftriaxone, erythromycin and tetracycline was 7.6%, 6%, 5.25%, 20.9%, 23.9% and 72.1%, respectively.ConclusionHigh rates of colonization by pathogenic MRSA strains is observed among HIV positive pediatric patients in the Amhara National Regional state.
Highlights
HIV-infected patients have increased Staphylococcus aureus colonization [1,2]
Colonization by S. aureus was associated with male gender (OR = 0.5869; 95% CI: 0.3812–0.9036; p-value = 0.0155), history of antibiotic use over the previous 3 months (OR = 2.3126; 95% CI: 1.0707–4.9948; p-value = 0.0329) and having CD4 T
Methicillin Resistant Staphylococcus aureus among Children cell counts of more than 350 x 106 cells / L (OR = 0.5739; 95% CI = 0.3343–0.9851; p-value = 0.0440)
Summary
HIV-infected patients have increased Staphylococcus aureus colonization [1,2]. As colonization by Methicillin Resistant S. aureus(MRSA) is associated with increased risk of infection by MRSA [1,3,4], individuals at risk for both the colonization and infection by MRSA may serve as sources of outbreaks in both hospital and community settings.Generally, MRSA colonization is said to occur in individuals who have frequent exposure to healthcare settings and in those with frequent antibiotic usage as well as immune suppression [1, 5,6,7]. As colonization by Methicillin Resistant S. aureus(MRSA) is associated with increased risk of infection by MRSA [1,3,4], individuals at risk for both the colonization and infection by MRSA may serve as sources of outbreaks in both hospital and community settings. MRSA infections are a challenge for physicians in developing countries to treat because of the limited choice of therapeutic options available [13] and due to the possibility of concomitant drug resistance of the MRSA to other antimicrobials. MRSA are a challenge to patients in developing settings due to increased cost of care [14, 15]. MRSA infections are a challenge to both physicians and patients due to limited choice of therapeutic options and increased cost of care
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