Detection of Multidrug Resistant Staphylococcus aureus at Morogoro Regional Referral Hospital, Tanzania

Abstract

Background: Hospital settings are associated with constant introduction of pathogens which can be transmitted among workers by patients, and visitors, resulting into potential nosocomial infections. This study compared the carriage and pattern of drug resistant S. aureus among patients and on equipment in hospital setting at Morogoro Regional Referral Hospital (MRRH). Methods: A cross sectional study was conducted by collecting samples from the anterior nares using sterile cotton swabs from patients. Furthermore samples were collected from inanimate surfaces, ward door handles; wheelchairs; and trolleys. The samples were incubated on mannitol salt agar plates aerobically at 37°C for 24 hours. Antimicrobial susceptibility testing was done using; erythromycin, azithromycin, ofloxacin, gentamicin, ciprofloxacin and cefoxitin. Clindamycin inducible resistance was tested by D test as per CLSI (2019). Data analysis was carried using SPSS where Chi – square was used to compare the association of occurrence of resistance and source of isolation. Results: Out of 200 samples, 54 tested positive for S. aureus were from human while the prevalence of S. aureus in inanimate objects was high in beds 10 (40%). The AMR was observed more in azithromycin (26.3%) than other antimicrobials. The D-Test showed inducible clindamycin-resistant phenotype in 57.1% of the MRSA isolates. The maternity ward had the highest risk of being exposed to S. aureus contamination [OR = 9.9 (95% CI, 2.0-19.30), p = 0.01] and tables [OR = 4.6 (95% CI, 1.22-1.89, p= 0.03)]. The recovery wards were least likely to be contaminated with the result of four times likely to be contaminate for both patients and surfaces [OR = 5.1 (95% CI, 1.3-8.6), p= 0.04] when compared with other wards. Conclusion: This study presents some important findings on MRSA which is a global concern, the authors encourages more researches are done in MRSA for efficient availability in the AMR database.