Infection and Drug Resistance (Jun 2022)
High Levels of Methicillin-Resistant Staphylococcus aureus Carriage Among Healthcare Workers at a Teaching Hospital in Addis Ababa Ethiopia: First Evidence Using mecA Detection
Abstract
Kassu Desta,1,2 Eleni Aklillu,3 Yirgu Gebrehiwot,4 Fikre Enquselassie5 ,† Daire Cantillon,6 Leena Al-Hassan,6 James R Price,6 Melanie J Newport,6 Gail Davey,5,6 Yimtubezenash Woldeamanuel1 1Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences (CHS), Addis Ababa University (AAU), Addis Ababa, Ethiopia; 2Department of Medical Laboratory Sciences, CHS, AAU, Addis Ababa, Ethiopia; 3Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska, Sweden; 4Department of Obstetrics and Gynecology, School of Medicine, CHS, AAU, Addis Ababa, Ethiopia; 5School of Public Health, CHS, AAU, Addis Ababa, Ethiopia; 6Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK†Fikre Enquselassie passed away on October 27, 2019Correspondence: Kassu Desta, Tel +251 911107099, Email [email protected]: Staphylococcus aureus is a major human pathogen and causes healthcare and community-acquired infection. Data on the extent of MRSA colonization among health-care workers (HCWs) in sub-Saharan Africa are limited. Hence, we determined the burden of MRSA colonisation among HCWs and administrative staff in Tikur Anbessa Specialised Hospital (TASH), College of Health Sciences (CHS), Addis Ababa University, Ethiopia.Methods: Using a cross-sectional study design, participants were screened for MRSA colonisation between June 2018 and August 2019 using nasal swabs. The swabs were analysed using standard laboratory methods including antibiotic resistance gene, mecA. Anonymised sociodemographic data were collected by pretested questionnaires to evaluate HCWs factors associated with MRSA carriage.Results: A total of 588 HCWs and 468 administrative staff were screened for MRSA. Women were over-represented. Overall, 49.1% (289/588) of HCWs were nurses and 25% (117/468) of the administrative staff were cleaners or laundry workers. Overall, 138 S. aureus isolates were retrieved from the nasal swabs of both groups (16.3%, 96/588 from HCWs). The burden of MRSA colonisation was 4.8% (28/580, 95% CI: 3.1– 6.5%) among HCWs compared to 0.2% (1/468, 95% CI: 0.18– 0.6%) of administrative staff (p value < 0.05). The majority of S. aureus and all MRSA isolates were resistant to penicillin. Isolates from HCWs were more resistant to tested antibiotics than administrative staff (P-value < 0.05).Conclusion: This is the first report in Ethiopia on MRSA colonization using mecA and revealed that; (i) overall carriage rates of MRSA in HCWs are comparable with observations reported in some other countries and (ii) HCWs exhibit a higher burden of MRSA carriage than administrative staff. Our data support strategic screening of MRSA and antimicrobial stewardship for better intervention measures.Keywords: MRSA, HCWs, administrative staff, mecA, TASH, Ethiopia
