Hospitalization and colonization by methicillin-resistant Staphylococcus aureus in the surgical department of 03 health facilities in the Ndé division, West-Cameroon

Abstract

Background Commensal flora colonization during hospitalization by bacteria is the first step for nosocomial infections while antibiotic resistance reduces therapeutic options. In aim to control this phenomenon, we initiated this study to describe the impact of hospitalization on colonization by methicillin-resistant Staphylococcus aureus in the surgical department of 03 health facilities in the Ndé division, West-Cameroon. Methods This study was carried out on patients admitted for surgery in 03 health facilities of the Ndé division, West-Cameroon (District Hospital of Bangangté, Protestant Hospital of Bangwa and Cliniques Universitaires des Montagnes). After obtaining ethical clearance and authorizations, nasal swabs were performed at admission and discharge, with the aim of isolating bacteria and performing their antibiotic susceptibility tests. Informations on each participant's antibiotic therapy were recorded. Laboratory investigations were carried out according to standard protocols (CASFM, 2019). Results The most commonly used antibiotics were β-lactams. A total of 104 nasal swabs were performed on 52 patients who agreed to participate to the study. From the analysis, 110 (57 at admission versus 53 at discharge) Staphylococcus isolates were obtained. Overall, susceptibility testing showed that antibiotic resistance rates were higher at discharge than at admission; with significant differences between the susceptibility profiles obtained at admission and discharge for β-lactams and not significant for fluoroquinolones and aminoglycosides. Globally, frequency of nasal carriage of methicillin-resistant Staphylococcus aureus at discharge 16 (30.77%) was significantly higher than at admission 07 (13.46%) with Chi-2 = 4.52 and p = 0.0335. Conclusion The high rates of antibiotic resistance of bacteria isolated at discharge compared to those isolated at admission obtained in the present investigation, highlights the important role that hospitalization plays in the selection and dissemination of methicillin-resistant Staphylococcus aureus and colonization by these bacteria in health structures of Ndé division. As a result, further investigations to find the factors that promote this phenomenon should be carried out.

A mapping review of methicillin-resistant Staphylococcus aureus proportions, genetic diversity, and antimicrobial resistance patterns in Cameroon

“…For inpatients, the traumatology unit showed a prevalence of 17.3% [31], while a higher prevalence of 34.6% was observed in general in-patient wards [26]. The surgical department of in-patient settings had a lower prevalence at 13.5% [35], like the intensive care units which stayed at 13.4% [27]. Mixed settings, which have encompassed various departments, displayed a diverse prevalence, ranging from 2.8% to 46.8% [20,24,37,39].…”

“…Finally, 24 studies were included in our review and met the criteria for MRSA proportions, genetic diversity, and antimicrobial resistance patterns in Cameroon [13,. Among the included studies, there were 22 studies on human MRSA epidemiology [13,[20][21][22][23][24][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41], one study on animal epidemiology [25], two studies on food epidemiology [19,21], one study on environmental epidemiology [38].…”

“…The review covers 10 regions of Cameroon, with the Central region having the highest frequency with 11 (36.67%) publications. Of the 24 studies included, 8 were conducted in the Central Region (33.3%) [13,22,24,27,37], and Five in the Western Region (20.8%) [30,32,35,36]. The Littoral (8.3%) [20,41] and South West (8.3%) regions [21,38] were studied twice each, while one study covered the Centre, Littoral, and South West regions (4.1%) [26].…”

“…Patients with skin and soft tissue infections had a prevalence of 13.2% [20], and those with suppurating wounds or abscesses reported 17.3% [31]. A broad spectrum was observed among patients with various diseases, with rates spanning from 13.4% to 46.8% [27,30,34,35,39]. Pregnant and non-pregnant individuals presented a rate of 41.1% [36], while mixed populations presented diverse prevalence ranging from 2.8% to 34.6% [24,26,32,38].…”