Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) is a well-recognized public health problem throughout the world. The evolution of new genetically distinct community-acquired and livestock-acquired MRSA and extended resistance to other non-β-lactams including vancomycin has only amplified the crisis. This paper presents data on the prevalence of MRSA and resistance pattern to other antibiotics on the selected specimen from two referral hospitals in Asmara, Eritrea. Method A cross-sectional study was conducted among 130 participants recruited from two referral hospitals in Asmara, Eritrea. Isolation of S. aureus was based on culture and biochemical profiles. Standard antimicrobial disks representing multiple drug classes were subsequently set for oxacillin, gentamicin, erythromycin, and vancomycin. Data were analyzed using SPSS version 20 software. Results S. aureus isolation rate from the 130 samples was 82 (63.1%). Patients <18 years of age were more likely to be colonized by S. aureus compared to patients above 61 years. The proportion of MRSA among the isolates was 59 (72%), methicillin-intermediate S. aureus (MISA) was 7 (8.5%), and methicillin-sensitive S. aureus (MSSA) was 15 (19.5%). The isolates were mostly from the pus specimen in burn, diabetic, and surgical wound patients. Antimicrobial susceptibility test showed that 13 (15.9%) of the isolates were resistant to vancomycin, 9 (11.0%) to erythromycin, and 1 (1.2%) to gentamicin. Coresistance of MRSA isolates to some commonly used antibiotics was also noted: oxacillin/erythromycin 5 (6.1%) and oxacillin/vancomycin 9 (11%). A few isolates were resistant to oxacillin/vancomycin/erythromycin 2 (2.4%) and oxacillin/gentamicin and erythromycin 1 (1.2%). Conclusion This study reports a relatively high prevalence of MRSA. Isolates that are resistant to other tested antibiotics including vancomycin are also reported. The data have important implication for quality of patients care in the two settings: antibiotic selection and infection control practices, and the need for additional studies.
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) is a well-recognized public health problem throughout the world. e evolution of new genetically distinct community-acquired and livestock-acquired MRSA and extended resistance to other non-β-lactams including vancomycin has only amplified the crisis. is paper presents data on the prevalence of MRSA and resistance pattern to other antibiotics on the selected specimen from two referral hospitals in Asmara, Eritrea
The frequency of isolation in males was 47 (61.8%) and that of females was 35 (64.8%), p value 0.642. e isolation rate of S. aureus was significantly associated with the study participants aged below or equal to 18 (AOR, 95% CI: 5.13 (1.50, 17.5), p 0.009)
Other isolates containing a particular variant of staphylococcal cassette chromosome mec (SCCmec) types II and III have expanded range of resistance due to the presence of additional resistance genes. e presence of PBP2a, or mecA positivity, can be typed using methicillin or oxacillin, the acronym MRSA- or oxacillin-resistant S. aureus (ORSA) [26]. is study was designed to determine the occurrence of MRSA in S. aureus isolates from inpatients at both Orotta Referral Hospital and Halibet Referral Hospital in Asmara, Eritrea
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) is a well-recognized public health problem throughout the world. e evolution of new genetically distinct community-acquired and livestock-acquired MRSA and extended resistance to other non-β-lactams including vancomycin has only amplified the crisis. is paper presents data on the prevalence of MRSA and resistance pattern to other antibiotics on the selected specimen from two referral hospitals in Asmara, Eritrea. Is paper presents data on the prevalence of MRSA and resistance pattern to other antibiotics on the selected specimen from two referral hospitals in Asmara, Eritrea. Isolates that are resistant to other tested antibiotics including vancomycin are reported. A multifactorial range of independent risk factors for MRSA has been reported in literature and include immunosuppression, hemodialysis, peripheral malperfusion, advanced age, extended in-hospital stays, residency in long-term care facilities (LTCFs), inadequacy of antimicrobial therapy, indwelling devices, insulin-requiring diabetes, and decubitus ulcers, among others [2]. In Europe, data from the European Antimicrobial Resistance Surveillance System (EARSS) reported that prevalence of HA-MRSA in acute care and long-term settings ranged between 1% and 24% with considerable intracountry and intercountry variation [7, 8]. Additional literature from panEuropean surveys suggest that MRSA affects >150,000 patients annually in the European Union (EU) and accounts for 380 million Euros in extra in-hospital costs for EU healthcare systems [4] and that the average excess costs per MRSA-positive patient ranged from 5,700 to 10,000 Euros [9]
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