Methicillin resistant Staphylococcus aureus causing osteomyelitis in a tertiary hospital, Mwanza, Tanzania

Abstract

Background: Culture results of fluid/pus from sinuses or open wound are not reliable in establishing the causative agent of osteomyelitis due to the high chances of contamination of superficial contaminants. Bone fragments obtained during surgery have been recommended as ideal sample to establish pathogens causing osteomyelitis. This study investigated pathogens causing osteomyelitis among patients undergoing orthopedic surgical treatment at Bugando Medical Centre. Methods: A cross-sectional hospital-based study was conducted from December 2017 to July 2018 among 74 patients with osteomyelitis who underwent surgical treatments at Bugando Medical Centre, Mwanza, Tanzania. Bone fragments were collected using sterile 10 ml of in-house prepared brain heart infusion broth (Oxoid, UK) during surgery. Specimens were processed according to standard operating procedures within an hour of collection. Data were analyzed using STATA 13.0. Results: The median age of study participants was 12 with inter quartile range of 8-20 years. The majority 45 (60.8%) of participants were male. All 74 non-repetitive bone fragment specimens had positive culture, of which 17 had dual growth of bacteria resulting to 91 bacterial isolates. Out of 91 isolates, 63 (85.1%) were Staphylococcus aureus (S. aureus) of which 18 (28.6%) were confirmed to be methicillin resistant Staphylococcus aureus strains. Fever was significantly associated with Staphylococcal osteomyelitis (100% vs. 79.6%, p = 0.029). Conclusion: About one third of cases of Staphylococcal osteomyelitis in the current study were caused by methicillin resistant Staphylococcus aureus. There is a need of tailoring antibiotic management of osteomyelitis based on culture and sensitivity results for the better treatment outcome of the patients.

Bacteria Patterns on Tonsillar Surface and Tonsillar Core Tissue among Patients Scheduled for Tonsillectomy at Bugando Medical Centre, Mwanza, Tanzania

“…Methicillin-resistant Staphylococcus aureus (MRSA) was observed in 39% of isolates. This was within the range (28.6-50%) of MRSA reported by different studies conducted in the same setting among patients with different infections [19][20][21]. A similar resistance trend was reported in India [5].…”

Antibacterial activity of soil-isolated Bacillus altitudinis/pumilus complex against methicillin-resistant Staphylococcus aureus from Mwanza, Tanzania

“…The well diffusion method, as described by Yilmaz and colleagues, 18 was used to test the antibacterial activity of the extracted metabolites against one isolate each of extended-spectrum beta-lactamase-producing and non-producing E. coli and K. pneumoniae , MRSA and methicillin-susceptible S. aureu s, inducible clindamycin-resistant S. aureus , coagulase-negative staphylococci, and Streptococcus pyogenes . These bacterial pathogens were isolated from clinical samples of previous studies conducted in the same setting 19 , 20 and archived at –80 °C in 20% glycerol stocks. The recovery of these bacterial strains was performed by subculture on BA plates which were incubated at 37 °C for 24 h. Bacterial suspensions of these test strains were prepared using sterile saline and adjusted to 0.5 McFarland standard solution (Remel, Lenexa, Kansas, United States).…”

From skin infection to invasive diseases: A descriptive review of Staphylococcus aureus, focusing on Panton-Valentine leucocidin and methicillin-resistant strains

“…It was reported that during osteomyelitis, S. aureus presented 60.5% of positive cases in culture (Weiss et al, 2020). In addition, another study has confirmed the high prevalence of staphylococcal osteomyelitis with 85.1% of cases (Silago et al, 2020). According to Urish and Cassat (2020), treatment of osteomyelitis has remained largely unchanged over the past decades and focuses on personalized antibiotic therapy with correction of medical co-morbidities (Urish and Cassat, 2020).…”