The Prevalence Of Methicilin Resistant Staphylococcus Aureus And Associated Risk Factors Among Patients With Wound Infection At Dessie Referral Hospital, Northeast Ethiopia

Abstract

Back ground: The emergence of Methicilin resistant Staphylococcus aureus (MRSA) has posed serious therapeutic challenges globally. The aim of this study was to determine the prevalence of MRSA infection and related risk factors among patients suffering from wound infection.

Materials and Methods: A hospital based cross-sectional study was conducted among patients suffering from wound infection. Socio-demographic characteristics and potential risk factors were assessed using a pre-tested and structured questionnaire. Wound swabs were collected following Levine’s technique and deposited in a tube that had brain heart infusion. Each wound specimen was inoculated on Blood agar plate (BAP), MacConkey agar (MAC), and Mannitol salt agar (MSA) then incubated at 37^OC for 24 hrs. S. aureus suspected colonies were identified using standard laboratory procedures and MRSA was determined based on the resistance pattern of cefoxitin.

Results: A total of 266 wound swabs were investigated and 66.2% were found positive for bacterial pathogens. The overall prevalence of S. aureus was 34.6%. The prevalence of MRSA infection was 28.3% (26/92) and that of Methicilin sensitive Staphylococcus aureus (MSSA) was 71.7% (66/92). All MRSA isolates were resistant to penicillin. On the other hand, 61.5% of the MRSA isolates were resistant to erythromycin and ciprofloxacin and 53.8% for cotrimoxazole and gentamicin. However, MRSA isolates demonstrated lower resistance to clindamycin (7.7%). Data also showed that 69.8% of the MRSA isolates showed multidrug resistance, but MDR among MSSA isolates were only 3%. Hospital admission (P = 0.006), Low BMI (P<0.001) and  farming occupation (P = 0.040) were the risk factors significantly associated with wound infection due to MRSA.

Conclusion: The prevalence of S. aureus infection was high, and a significant proportion of the isolates were Methicilin resistant. The occurrence of MRSA among patients with wound infection indicates a need for regular investigation of wound samples by culture and drug susceptibility testing.