Methicillin-resistant Staphylococcus aureus colonization and associated factors in clinical isolates among patients attending a tertiary medical centre in Nigeria.

BACKGROUND

The burden of methicillin-resistant Staphylococcus aureus (MRSA) constitutes a major public health issue globally. However, there is a paucity of information concerning the prevalence and trends in antibiotic resistance of MRSA in clinical samples in the study area. This study aimed to determine the prevalence and associated risk factors of MRSA in clinical isolates from patients at the Federal Medical Centre (FMC), Azare, Nigeria.

METHODS

A cross-sectional study was performed in a hospital from January to May 2024. A total of 210 clinical samples were collected from the study participants. Data concerning sociodemographic variables and associated risk factors were gathered using structured questionnaires. Clinical samples were obtained aseptically, and S. aureus was identified using standard microbiological methods. MRSA was detected using cefoxitin discs, and the antimicrobial Susceptibility profiles to different antibiotics were performed using the Kirby-Bauer disk diffusion method. Multivariate logistic regression tests were conducted, with a significance level set at P < 0.05.

RESULTS

Of the 210 blood, urine, and wound swab samples analyzed, the overall prevalence of S. aureus and MRSA was 13.8% (29/210; 95% CI: 9.40-19.20) and 4.2% (9/210; 95% CI: 2.0-8.0), respectively. The multivariate analysis indicates that female (AOR) (95% CI): 10.023 (1.033-97.228)], wound swab specimen (AOR) (95% CI): 12.860 (1.236-133.833)] and history of hospitalization (AOR) (95% CI): 10.223 (1.712-61.044) were associated with MRSA infection. All 9 MRSA isolates showed resistance to penicillin, oxacillin, and cefoxitin, while others exhibited varying levels of resistance, with azithromycin showing the lowest resistance (66.7%). All the isolates showed multidrug resistance.

CONCLUSION

Based on the findings, the clinical samples showed a reduced incidence of MRSA compared to other studies conducted in Nigeria. The alarming factor is the presence of MDR in all MRSA isolates, emphasizing the need for regular testing to prevent endogenous infections.