Methicillin and Vancomycin Resistant Staphylococcus aureus and Associated Factors from Surgical Ward Inpatients at Debre Markos Referral Hospital, Northwest Ethiopia

Abstract

Background: Staphylococcus aureus is one of the leading wound infections. It is considered as a super bug. The epidemiology of Methicillin Resistant S. aureus (MRSA) and Vancomycin Resistant S. aureus (VRSA) is not well studied in Ethiopia particularly in Debre Markos Referral Hospital (DMRH). The objective of the study was to determine the prevalence of MRSA and VRSA and associated factors from wound cases admitted to surgical ward in DMRH, Northwest Ethiopia.Methods: A cross-sectional study was conducted from February-April 2020 at DMRH. A structured questionnaire was used to collect demographic and clinical characteristics. Wound swabs were collected using sterile cotton swab followed by culturing on Blood agar and Mannitol Salt agar. Then isolates were characterized by gram stain and biochemical tests. The presence of MRSA and VRSA was determined using the cefoxitin (30μg) antibiotic disc diffusion and vancomycin E-test, respectively. The data was analyzed using Statistical Package for Social Sciences, version 20 software. P-value <0.05 was considered statistically significant.Results: A total of 242 wound cases were enrolled and a majority of them were males (172, 71.1%). Among the total wound cases, the isolation rate of S. aureus was 29.3%. The proportion of MRSA was 13.22% and that of VRSA was 4.1%. The proportion of vancomycin intermediate S. aureus (VISA) was gauged at 4.5%. Hospital stay >72h (p=0.014), wound depth (p=0.043), antibiotic use (p=0.017) and previous history of wound infection (p=0.001) showed statistical significant association with MRSA. No variables showed significant association with VRSA.Conclusion: High proportions of S. aureus isolates are resistant to methicillin and vancomycin. Moreover, multiple variables demonstrated associations with drug resistance. Hence, hospital infection control and antibiotic stewardship program shall be strengthened.