Methicillin-resistant staphylococcus aureus (MRSA) colonization among Intensive Care Unit (ICU) patients and health care workers at Muhimbili national hospital, Dar Es Salaam, Tanzania, 2012

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.

Nasal Carriage of Methicillin-Resistant Staphylococcus aureus among Health Care Workers in Tertiary and Regional Hospitals in Dar es Salam, Tanzania

“…We found a high prevalence of MRSA carriage (15.6%) among HCWs from the four hospitals investigated in this study. This prevalence is higher than the previous MRSA carriage reported in the region including 2.1% at MNH in Dar es Salaam [ 18 ] and 12.7% in Ethiopia [ 22 ]. It is also higher than that reported in the Middle East and Asia, 5.3% in Iran [ 26 ], and 3.4% in Nepal [ 27 ].…”

“…We have recently reported an MRSA prevalence of 8.5% on admission among patients attending two regional hospitals in Dar es Salaam [ 17 ]. There 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 ]. Thus, 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.…”

Prevalence and characteristics ofStaphylococcus aureusand methicillin‐resistantStaphylococcus aureusnasal colonization among a community‐based diabetes population in Foshan, China

“…We found that S. aureus strains of both the diabetes population and non-diabetes population in the present study were highly resistant to erythromycin and penicillin, which was similar to several other studies 20,38,39 . This might be as a result of the extensive use of these antibiotics in medical institutions.…”

Hospital Epidemiology of Methicillin-ResistantStaphylococcus aureusin a Tertiary Care Hospital in Moshi, Tanzania, as Determined by Whole Genome Sequencing

“…However, given the low research intensity on MRSA infections in Africa this data should not be neglected [ 16 ]. S. aureus and MRSA infections contribute to significant health challenges in Tanzania as well [ 17 – 19 ] despite the fact that the reports are few and hence the current prevalence may not be indicating the actual disease burden. It is therefore important to be able to explain the molecular epidemiology of the clones, which are locally circulating.…”