Nasal Carriage Rate Of Methicillin Resistant Staphylococcus Aureus, Antimicrobial Susceptibility Pattern And Associated Risk Factors Among Pregnant Women At The University Of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia

Abstract

Background: Methicillin-resistant S. aureus (MRSA) infection has become a significant burden worldwide that poses a formidable clinical threat, with persistently high morbidity and mortality and successful treatment remains challenging. Pregnant mothers are at increased risk of acquiring MRSA during their frequent checkups at health institutions. Indeed, there is a paucity of information on the nasal carriage rate of MRSA among pregnant women. The aim of this study was to determine the nasal carriage rate of MRSA, antimicrobial susceptibility patterns, and associated risk factors among pregnant women attending the University of Gondar Compressive Specialized Hospital.

Method: A hospital-based cross-sectional study was carried out involving a total of 423 pregnant women from February-April 2020. A systematic random sampling technique was used to recruit the study participants. Nasal swabs were collected and inoculated on Mannitol salt agar and blood agar then incubated at 35°C for 24hrs. Gram stain, catalase and coagulase tests were performed. Antimicrobial susceptibility tests were performed on Muller Hinton agar. Methicillin resistance was detected using a cefoxitin disc. Staphylococcus aureus ATCC 25923 was used as quality control. Data were entered using Epi-Info version 7 and analyzed using SPSS version 20 statistical software. The association between outcome and risk factors was done using the Pearson Chi-square test. P-value < 0.05 was considered to be statistically significant.

Result: S. aureus and MRSA were isolated in 60/423 (14.2%) and 8/423 (1.9%) of the study participants, respectively. The highest isolation rates of total S. aureus and MRSA isolate were found in the age group 31-40 years and in urban dwellers. One hundred percent of the MRSA strains were sensitive to erythromycin and clindamycin. Nasal carriage of MRSA was significantly associated with age, history of having a respiratory infection, history of hospitalization, history of contact with a person with skin infection, and history of sharing personal items such as towels or razors.

Conclusion: The result of this study indicated that a considerable amount of MRSA nasal colonization is observed. Hence, routine screening of pregnant women is important to prevent endogenous infections and the spread of MRSA.