Abstract
Background: Young children are major reservoir for community acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) and accelerate transmission of CA-MRSA. Objective: The aim of this study was to determine the nasal carriage and antimicrobial resistance patterns of MRSA isolates among school children in Bahir Dar town, Ethiopia. Methods: A community based cross-sectional study was conducted to determine the nasal carriage rate and antimicrobial susceptibility pattern of MRSA isolates among school children. A total of 300 nasal swabs were collected from March 1 to June 30, 2013. MRSA was detected using both Cefoxitin (30 μg) and Oxacillin (1 μg) discs in combination and risk factors were assessed using self-administered structured questionnaires. Statistical analysis was done using SPSS V-20. Result: Of 123 S. aureus isolates 17(13.8%) were MRSA isolates. The main risk factors for nasal carriage of MRSA in the study area were, having recurrent acute otitis media and use of an antibiotic in the previous year. The Susceptibility profiles of MRSA isolates were (94.1%) to Chloramphenicol, Ciprofloxacin and Clindamycin, (88.2%) to Ceftriaxone, Erythromycin and Trimethoprim-sulphamethoxazole and (58.8%) to Doxycycline. All the isolates were resistant to Penicillin G and sensitive to Gentamycin. Conclusion: This study showed a rising rate of nasal carriage of MRSA among school children. Previous use of antibiotics by the children was statistically associated with MRSA carriage. Therefore developing decolonization protocols and proper utilization of drugs are needed in order to reduce the transmission and the burden of MRSA.
Highlights
Anterior nares are the most consistent site of colonization for Staphylococcus aureus
This shows that, young children were the major reservoir of MRSA in the community and were the main population responsible for the accelerated transmission of community acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) and colonization with MRSA has a 25% probability of acquiring the infection than methicillinsensitive Staphylococcus aureus (MSSA) [2,3]
This increased isolation rate of MRSA could be due to differences in isolation technique and there might be specific risk factors which are not assessed by this study that might increase the isolation rate
Summary
Anterior nares are the most consistent site of colonization for Staphylococcus aureus. Living with young children was associated with increased risk of MRSA colonization in adults [3]. This shows that, young children were the major reservoir of MRSA in the community and were the main population responsible for the accelerated transmission of CA-MRSA and colonization with MRSA has a 25% probability of acquiring the infection than methicillinsensitive Staphylococcus aureus (MSSA) [2,3]. Treatment of serious S. aureus infections can be challenging, and the associated mortality rate, among children, remains 20-25% despite the availability of highly active antimicrobial agents. Young children are major reservoir for community acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) and accelerate transmission of CA-MRSA
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