Abstract
IntroductionMethicillin-resistant Staphylococcus aureus (MRSA) has been recognized as important nosocomial pathogens worldwide. S aureus may induce clinically manifested diseases, or the host may remain completely asymptomatic.MethodsA cross-sectional hospital-based study was conducted from October 2012 to March 2013 in two ICUs at MNH. Admitted patients and health care workers were enrolled in the study. Interviewer administered questionnaires; patient history forms, observation charts and case report forms were used to collect data. Swabs (nostrils, axillary or wounds) were collected. MRSA were screened and confirmed using cefoxitin, oxacillin discs and oxacillin screen agar. Antibiotic susceptibility was performed using Kirby-Bauer disk diffusion method. The risk factors for MRSA were determined using the logistic regression analysis and a p - value of <0.05 was considered as statistically significant.ResultsOf the 169 patients and 47 health workers who were recruited, the mean age was 43.4 years ± SD 15.3 and 37.7 years ± (SD) 11.44 respectively. Among the patients male contributed 108 (63.9%) while in health worker majority 39(83%) were females. The prevalence of MRSA colonization among patients and health care workers was 11.83% and 2.1% respectively. All (21) MRSA isolates were highly resistant to penicillin and erythromycin, and 17 (85.7%) were highly sensitive to vancomycin. Being male (AOR 6.74, 95% CI 1.31-34.76), history of sickness in past year (AOR 4.89, 95% CI 1.82- 13.12), being sick for more 3 times (AOR 8.91, 95% CI 2.32-34.20), being diabetic (AOR 4.87, 95% CI 1.55-15.36) and illicit drug use (AOR 10.18, 95%CI 1.36-76.52) were found to be independently associated with MRSA colonization.ConclusionA study identified a high prevalence of MRSA colonization among patients admitted in the ICU. MRSA isolates were highly resistant to penicillin and erythromycin. History of illegal drug use was highly associated with MRSA colonization.
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) has been recognized as important nosocomial pathogens worldwide
The respondent was a male, 26 years old residing in Dar es Salaam with tertiary educational level and assistant nurse by profession All 21(100%) MRSA isolates were resistant to penicillin and erythromycin, and 16(76.2%) to clindamycin while majority 18(85.7%) were sensitive to vancomycin
Being male and history of illicit drug uses were found to be independently associated with MRSA colonization.Table 3 summarizes the multivariate analysis of risk factors of MRSA colonization among patients admitted
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) has been recognized as important nosocomial pathogens worldwide. When present in a host, S. aureus may induce clinically manifested diseases, or the host may remain completely asymptomatic; this condition is known as colonization [2] These MRSA infections are generally seen in individuals who have ongoing interactions with the healthcare system for example dialysis patients and these infections may develop in these individuals as outpatients [3]. There was limited data on magnitude of MRSA and risk factors in Tanzania among patients admitted at the ICU and health care workers working in the facility. A study was conducted to determine the magnitude of and risk factors for MRSA colonization among ICU patients and health care workers at MNH, in Dar es Salaam
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