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|Title: ||Prevalence and risk factors of nasal carriage of methicillin-resistant staphylococcus aureus (MRSA) among Hospitalized patients at the Komfo Anokye Teaching Hospital, Kumasi, Ghana.|
|Authors: ||Kutu, Emmanuel Donawobuge|
Methicillin-Resistant Staphylococcus Aureus
Komfo Anokye Teaching Hospital
|Issue Date: ||22-Jul-2021|
|Abstract: ||Methicillin-Resistant Staphylococcus aureus (MRSA) is implicated in several nosocomial
infections, some of which are life threatening. It is carried asymptomatically in the nasal
cavity and other parts of the human body. This asymptomatic carriage serves as an important
source of transmission of the organism to other patients, especially within a confined place
such as the hospital wards. There is limited data on the prevalence of Methicillin-Resistant S.
aureus (MRSA) among hospitalized patients in Komfo Anokye Teaching Hospital (KATH).
This study aimed to establish the prevalence and risk factors of MRSA nasal carriage among
hospitalized patients at KATH in Kumasi, Ghana.
Informed consent was obtained from the patients and their nasal swabs were collected and
cultured overnight on mannitol salt agar (MSA) at 37oC under aerobic conditions.
Questionnaires were administered to patients to assess risk factors of MRSA nasal carriage.
The risk factors assessed included procedures the patients had undertaken (surgery, urinary
caterization etc), conditions of patients (chronic skin infection, chronic long disease etc.) and
history of previous hospitalization. Catalase and coagulase tests were performed on yellow
colonies from the overnight culture on MSA. Coagulase positive isolates were confirmed as
S. aureus by nucA PCR. The Kirby-Bauer disk diffusion method was used to test the
antibiotic susceptibility profile of the S. aureus isolates. Isolates that were resistant to
cefoxitin were confirmed as MRSA by PCR identification of the mecA gene.
Out of 224 in-patients samples, 31 (13.84%) were identified as S. aurueus. Of the 31 S.
aureus isolates, 14 were confirmed as MRSA, resulting in MRSA carriage of 6.25%. The
MRSA isolates showed high resistance against most of the antibiotics tested in this study,
including 86% against both erythromycin and amoxicillin/clavulanic acid. Resistance
proportions of the S. aureus isolates in general were 100% against penicillin and 97.06%
against ampicillin. The most effective antibiotic against the MRSA and the overall S. aureus
isolates was gentamicin, to which 79% of the MRSA isolates and 87% of the S. aureus
isolates were susceptible. Among the risk factors assessed, the highest nasal carriage
prevalence of MRSA i.e 50% was observed among patients with chronic hepatic disease,
followed by patients with burns who recorded 16.6% MRSA nasal carriage prevalence.
This study revealed that there is high prevalence of MRSA among the patients. This high
prevalence of MRSA poses a challenge to healthcare delivery at KATH as it constitutes a
transmission risk to other patients. It is recommended that healthworkers in KATH adhere
strictly to infection prevention and control measures to avoid passing on MRSA to other
patients. Further studies on genotyping are needed to ascertain if these nasal carriage MRSA
strains are the same strains circulating and causing infections among patients on admission in
|Description: ||A thesis submitted to the Department of Clinical Microbiology in partial fulfillment of the requirements for the Award of Master of Philosophy (Mphil.) Degree in Clinical Microbiology in the Department of Clinical Microbiology, School of Medicine and Dentistry, College of Health Sciences, KNUST, Ghana. 2019|
|Appears in Collections:||College of Health Sciences|
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