Epidemiological analysis of MRSA carriage rates and risk factors among patients in Ugandan referral hospitals: a statistical approach

Abstract

This study investigated the determinants of Methicillin-resistant Staphylococcus aureus carriage among hospitalized patients at Mulago National Referral Hospital, Uganda, between 2020 and 2023. Secondary data from 7,546 patients were analyzed using univariate, bivariate and multivariate statistical methods, including logistic regression. Descriptive analysis showed that the mean age of patients was 50 years, with an average hospital stay of 7 days. Nearly half were admitted to the general ward, while the remainder were evenly distributed between surgical wards and intensive care units. Most patients (70.5%) had a history of invasive procedures, 51% had comorbidities and 40% reported prior antibiotic use.Bivariate analysis indicated significant associations between MRSA carriage and gender, prior antibiotic use, invasive procedures, comorbidities and ward type. However, multivariate analysis revealed that prolonged hospital stay, previous antibiotic use, history of invasive procedures, ICU admission and older age were the strongest independent predictors of MRSA carriage. Gender, comorbidities and admission to the general ward were not significant after adjustment.The findings underscore that hospital-related and clinical exposures outweigh demographic characteristics in determining MRSA risk. Targeted interventions are recommended, including strict antimicrobial stewardship, enhanced infection prevention protocols and intensified screening in high-risk settings such as ICUs. Strengthening hospital practices and addressing modifiable risk factors will be critical in reducing MRSA carriage and improving patient outcomes at Uganda’s largest referral hospital.