Nasal Carriage, Risk Factors and Antimicrobial Susceptibility Pattern of Methicillin Resistant Staphylococcus aureus among School Children in Ethiopia

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 micro g) and Oxacillin (1 micro g) 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.