Methicillin Resistant Staphylococcus aureus among HIV Infected Pediatric Patients in Northwest Ethiopia: Carriage Rates and Antibiotic Co-Resistance Profiles

Abstract

BackgroundMRSA infections are becoming more prevalent throughout the HIV community. MRSA infections are a challenge to both physicians and patients due to limited choice of therapeutic options and increased cost of care.ObjectivesThis study was aimed to determine the prevalence of colonization and co-resistance patterns of MRSA species among HIV positive pediatric patients in the Amhara National Regional State, Northwest Ethiopia.MethodsCulture swabs were collected from the anterior nares, the skin and the perineum of 400 participants. In vitro antimicrobial susceptibility testing was done on Muller Hinton Agar by the Kirby-Bauer disk diffusion method, using 30 μg cefoxitin (OXOID, ENGLAND) according to the recommendations of the Clinical and Laboratory Standards Institute. Methicillin sensitivity/resistance was tested using cefoxitin. Data was analyzed by descriptive statistics and logistic regression model using Epi Info 7.Results S. aureus was detected in 206 participants (51.5%). The prevalence of MRSA colonization in this study was 16.8%. Colonization by S. aureus was associated with male gender (OR = 0.5869; 95% CI: 0.3812–0.9036; p-value = 0.0155), history of antibiotic use over the previous 3 months (OR = 2.3126; 95% CI: 1.0707–4.9948; p-value = 0.0329) and having CD4 T-cell counts of more than 350 x 106 cells / L (OR = 0.5739; 95% CI = 0.3343–0.9851; p-value = 0.0440). Colonization by MRSA was not associated with any one of the variables. Concomitant resistance of the MRSA to clindamycin, chloramphenicol, co-trimoxazole, ceftriaxone, erythromycin and tetracycline was 7.6%, 6%, 5.25%, 20.9%, 23.9% and 72.1%, respectively.ConclusionHigh rates of colonization by pathogenic MRSA strains is observed among HIV positive pediatric patients in the Amhara National Regional state.

Prevalence and molecular epidemiology of methicillin-resistant Staphylococcus aureus colonization with and without methicillin-resistant coagulase-negative Staphylococci in HIV-infected patients

“…High proportions of resistance to penicillin, erythromycin, clindamycin and tetracycline were found in MRSA isolates, which is similar to observed studies [23][24][25]. This finding suggests medical professionals should pay more attention to the rational use of these antibiotics.…”

Carriage of Methicillin-resistant Staphylococcus aureus among people living with HIV-AIDS in inner São Paulo State, Brazil: molecular and spatial epidemiology

“…First, we documented colonization with MRSA among PLWHA from inner São Paulo State. The point prevalence rate (2.4%) is not particularly high when compared to the international literature -where prevalence of up to 16.8% are reported [23]. In fact, our rate is lower than the pooled prevalence of 6.9% reported in a recent meta-analysis [33].…”

“…Recent studies emphasize the intersection of HIV and CA-MRSA pandemics [19], [20], [21] Prevalence of colonization in this group is variable -with studies reporting rates ranging from similar to those reported for the general population [22] up to more than 16% [23].…”

Resistance pattern of methicillin resistant Staphylococcus aureus among nasal isolates of HIV infected patients in a tertiary care hospital

“…Our prevalence of nasal carriage S. aureus was near about similar as reported by various others authors. 17,18 The Contrast finding was also reported by various authors. 3,19,20 Higher prevalence may be due to the immunocompromised status, frequent contact with both health care and community settings and frequent exposure to antibiotics; becoming them colonized with resistant strains which is also proposed by Hidron AI et al 4 Cefoxitin disc diffusion showed 100% specific (95% CI; 97.05%-100.00%), 100% sensitive (95% CI; 83.89%-00.00%) and 100% accurate (95% CI; 97.47% to 100.00%) method while comparing with gold standard mecA gene PCR.…”