Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) among health care workers (HCWs) increases the risk of spreading the organism in hospital settings. A cross-sectional study was conducted between June and October 2016 among HCWs in tertiary and regional hospitals in Dar es Salaam, Tanzania, to determine the MRSA nasal carriage rate. Nasal swabs were collected from HCWs and cultured on mannitol salt agar. S. aureus was identified based on colonial morphology, Gram staining, catalase, coagulase, and DNase test results. MRSA was detected using the cefoxitin disk. Among 379 HCWs enrolled, 157/379 (41.4%) were colonized with S. aureus, of whom 59 (37.6%) were MRSA carriers giving an overall prevalence of 59/379 (15.6%). MRSA carriage was high among HCWs in Temeke (56.9%) and Amana (37.5%) regional hospitals. A high proportion of MRSA carriage was detected among nurses (35, 45.5%). MRSA isolates showed high resistance toward kanamycin (83.7%), gentamicin (83.1%), ciprofloxacin (71.2%), and trimethoprim-sulphamethoxazole (46.8%) compared to methicillin-sensitive S. aureus isolates (p ≤ 0.001). In conclusion, we found a high nasal carriage of MRSA and resistance to commonly prescribed antimicrobial agents among HCWs. Implementation of infection control measures including contact precautions, urgent reporting of MRSA laboratory results, and routine MRSA screening of HCWs is highly needed to reduce MRSA spreading.
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as a major nosocomial pathogen that causes severe morbidity and mortality worldwide [1, 2]
MRSA prevalence is high among health care workers (HCWs), and there is a dynamic spread of strains across the globe. e prevalence varies from hospital to hospital in various countries, with high rates (32–52%) reported mainly in the developing countries [3, 4]
We have recently reported an MRSA prevalence of 8.5% on admission among patients attending two regional hospitals in Dar es Salaam [17]. ere is paucity of data on MRSA carriage among HCWs in Tanzania, with only two studies reporting a prevalence of 2.1% in Dar es Salaam and 0.3% in Mwanza regions [18, 19]. us, the aim of this study was to determine the rate of MRSA nasal carriage among HCWs at tertiary and regional hospitals in Dar es Salaam, Tanzania, in order to obtain objective findings that can inform the development of evidence-based control and preventive measures
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as a major nosocomial pathogen that causes severe morbidity and mortality worldwide [1, 2]. MRSA prevalence is high among health care workers (HCWs), and there is a dynamic spread of strains across the globe. MRSA carriage among HCWs can render other measures of infection control ineffective [5, 6]. It has been reported that HCWs have been the source of MRSA outbreaks in several hospital settings [6]. E spread of MRSA strains in resource-limited settings may cause devastating consequences due to lack of adequate facilities for laboratory detection and patient management [7]. MRSA carriage is an important predisposing factor for developing MRSA infection [8], and this increases the cost of patient care. Given the impact of MRSA infection, early identification of colonized patients and HCWs and implementing control
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