Methicillin-resistant Staphylococcus aureus isolates from clinical samples received at Makerere University Clinical Microbiology Laboratory from 2017 to 2020.

Abstract

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent among patients admitted to hospital wards, and is on the rise as a community associated infection. Laboratory surveillance of distribution patterns of MRSA is important for monitoring and control of the spread of MRSA infection. Aim: This study aimed at determining the proportion and distribution of MRSA in clinical samples received at the Makerere University Clinical Microbiology laboratory, and the patient factors associated with MRSA infection. Methodology: This was a retrospective study conducted at the Clinical Microbiology Laboratory of Makerere University, College of Health Sciences. Information about the patient, bacterial culture and antimicrobial sensitivity data from 2017 to 2020 were abstracted from laboratory records.Data collected was entered into a data capture tool (EpiData), validated and exported to STATA Version 16 for analysis. Logistic regression analysis, and Chi-squared tests were done, andp-values less than 0.05 were considered statistically significant. Results:From 2017 to 2020, a total of 10,292 clinical samples werereceived, processed and tested at the microbiology laboratory. Staphylococcus aureus was isolated from 156 (1.52%) of the samples and of these, 44 (28.21%) were MRSA; that is 0.43% of the total number of clinical samples.Most (71.15%) of the MRSA isolates were obtained from blood samples.Patients aged < 5 years accounted for the greatest proportion (47.73%) of MRSA isolates. There were more MRSA isolates from samples obtained from male patients (63.64%) than female patients. The out-patient department (OPD) accounted for the greatest proportion of MRSA isolated among the hospital wards.There was a statistically significant relationship (p = 0.039) between MRSA infection and samples collected from the paediatrics ward. Conclusion: The proportion of MRSA isolates from clinical samples is low, and seems to be declining over the years. There is an underlying challenge of invasive Staphylococcal infections (Blood Stream Infections) in hospitals, especially among patients aged < 5 years and those admitted to the pediatric ward. The underlying causes of these observations deserve more comprehensive investigation and research so as to find befitting solutions.