Prevalence and risk factors of methicillin-resistant Staphylococcus aureus colonization among HIV patients in Mekelle, Northern Ethiopia

Abstract

HIV-positive individuals are at higher risk of Methicillin Resistant Staphylococcus aureus (MRSA) colonization and its related infection. There is limited data in the nation on the prevalence and risk factors of MRSA colonization among HIV patients. The aim of this study was to address the existing knowledge gap. Cross sectional study was carried out from September 2014 to February 2015 in three selected health centers and one general hospital. A standardized questionnaire was developed for collection of socio-demographic and clinical data. A total of 498 Nasal and throat swabs (two for each patient) were collected from 249 patients, transported and processed using standard bacteriological procedures. Data was analyzed using Chi square (X2) test and associated risk factors were determined. P < 0.05 was considered statistically significant. Out of 249 study participants, S. aureus was isolated from 81 (32.5 %) patients, with MRSA colonization rate of 6 (2.4 %). MRSA isolates were resistant to Ciprofloxacin and trimethoprim-sulphamethoxazole (16.7 % each), clindamycin (33.3 %) and erythromycin (50 %). However, all MRSA isolates were 100 % sensitive to Amikacin. History of hospitalization, percutaneous device usage, patients with a household member’s hospitalization and low CD4 count (<200 cells/mm3) were significantly associated with S. aureus colonization (p < 0.05).

Pharyngeal colonization and drug resistance profiles of Morraxella catarrrhalis, Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae among HIV infected children attending ART Clinic of Felegehiwot Referral Hospital, Ethiopia

“…In this study, the pharyngeal colonization rate of S . aureus (29.3%) is consistent with an earlier finding in Mekelle, Ethiopia (32.5%) [ 23 ]. However, it was lower than studies done in Gondar, Ethiopia (51.5%) [ 9 ] and Tanzania (66%) [ 33 ].…”

“…The carriage rate of MRSA in the present study (33%) was higher than previous studies in Mekelle, Ethiopia (2.4%) [ 23 ] and Ghana (3.4%) [ 3 ]. The higher carriage rate of MRSA in the current study might be due to the high visit of these patients to the health care settings, since repeated visits to health care settings or contact with the hands of health care workers in HIV infected individuals is the major risk factor for the colonization.…”

“…Although cotrimoxazole prophylaxis and pneumococcal conjugate vaccine for HIV infected individuals have been started to prevent the development of some of the most serious and common childhood bacterial opportunistic infections, the current pharyngeal colonization rate of bacterial pathogens was in accord with various studies for individual pathogens [ 23 – 27 ]. These imply that HIV infected children could be sources of bacterial infection to other school children and families posing high risk of developing invasive and non-invasive bacterial diseases.…”

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

“…To the best of our knowledge, and search, this is the first report of MRSA colonization among PLWHIV attending Nyenga Hospital in Buikwe district. The prevalence of MRSA reported here was 5.02% (95% confidence interval: 3.67-7.02), comparable to the 5.1% reported in Singapore [22], and slightly higher than 2% that was reported in Spain [23] and 2.4% in northern Ethiopia [24]. On the other hand, the prevalence is lower than 15.4% reported among an adult cohort from Johns Hopkins University AIDS Service in Baltimore [25], and 16.8% in Northeast Ethiopia [26].…”

“…The low prevalence of MRSA colonization in this study is ascribed to the occasional visit of PLWHIV to the health facility, since repeated visits or contact with hands of health workers in HIV infected individuals is the major risk factor for colonization [24,25]. resistance.…”