Perspective for Methicillin-resistant Staphylococcus Aureus colonization, Antibiotic Susceptibility Patterns and Risk factors for Colonization among People Living with HIV at Nyenga Hospital, Buikwe District, in Central Uganda

Abstract

Background Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an association towards development of infections that may cause of morbidity among people living with Human Immunodeficiency Virus (PLWHIV). We report on the prevalence, antibiotic susceptibility pattern and risk factors associated with MRSA carriage among PLWHIV at Nyenga hospital, Buikwe district in central Uganda. Materials and Methods We conducted a cross-sectional study among PLWHIV attending Nyenga hospital anti-retroviral therapy (ART) clinic. Nasopharyngeal swab was collected from each participant, cultured to isolate Staphylococcus aureus, and drug susceptibility testing (DST) performed. Sociodemographic data and medical history was recorded. Results We enrolled 219 PLWHIV; of these, 58.4% (N=128) were females. The majority of participants (95.0%) were on ART. Ninety-eight (44.75%) of the nasopharyngeal swabs had growth, of which 41 (41.84%) were S. aureus. Of these, 11 (5.02%, 95% confidence interval: 3.67-7.02) were MRSA. Of 41 isolated S. aureus strains, only 8 (19.51%) were susceptible to all antibiotics tested. A total of three (7.32%) were multi-drug resistant (MDR), while one1 (2.43%) was a possible extensively drug resistant (XDR) strain. Deteriorating immunologic state as indicated by a low CD4 count showed a significant association with the MRSA colonization. Conclusion These results are reassuring that MRSA colonization is high among PLWHIV. As most of the antibiotics in use were resistant, it raises concerns of intricate clinical management in a low resource set up.

Methicillin resistance Staphylococcus aureus nasal carriage and its associated factors among HIV patients attending art clinic at Dessie comprehensive specialized hospital, Dessie, North East Ethiopia

“…In the present study the whole isolates of S. aureus including MRSA showed full resistance for Penicillin which is in agreement with a study conducted in Uganda [18]. Like the present study another study [8] also indicated all MRSA isolate were found to be resistance to cefoxitin and penicillin.…”

“…with a study conducted in Ethiopia among pediatric HIV patients [2] but another study in Ethiopia reported a lower prevalence of S. aureus colonization among adult HIV patients (39.7%) [6]. Still, a very low rate was also reported in another similar studies in Ethiopia, other African countries and China [10,17,18,27]. In contrary to the present study almost two fold higher MRSA colonization was reported in a study conducted in East Africa [28].…”

“…In the present study it was revealed that none of the isolates showed full level of sensitivity for the tested antibiotics. Whereas, few other similar studies indicated full sensitivity to the tested drugs [6,17,18]. This variation might be due to difference in the selection of antibiotics across different studies including the current one.…”

“…Different studies across various countries, particularly in Africa, reported low to high nasal colonization of S. aureus and MRSA strain among HIV patients [9,10,[17][18][19]. The rate of colonization was also affected by different factors such as antibiotic usage, CD4 count, history of hospitalization, viral load and so on [6,17,20,21].…”

“…The isolates were also fostering wide ranged degree of resistance for antimicrobial agent [6,18,23]. As a result of colonization of MRSA either in the healthcare locations or in the community various forms of infection have been developed.…”