Methicillin-Resistant <i>Staphylococcus aureus</i> (MRSA) carriage and susceptibility patterns in patients admitted to critical care units in a central referral hospital in Harare, Zimbabwe

Abstract

Objectives: To determine Methicillin-Resistant Staphylococcus aureus (MRSA) carriage and antibiotic susceptibility patterns in patients admitted to critical care units in a central hospital in Harare Zimbabwe

Design: A cross sectional study of patients admitted to Critical Care Units (CCUs), to determine the Methicillin-Resistant Staphylococcus aureus (MRSA) carriage rate and susceptibility patterns of MRSA isolates.

Setting: Parirenyatwa Hospital, a major referral centre in Zimbabwe.

Subjects: Patients admitted to the Intensive Care Unit (ICU), CCU and Burns wards.

Results: Eighty of the 164 patients admitted between February and April 2014 were enrolled into the study. Of the 80 patients admitted to CCUs and recruited into the study 39 (48.8%) carried S. aureus of which 16were methicillin-resistant. The overall MRSA carriage rate was 20%. Thirteen (81%) of the MRSA isolates were from the nasals and 3 (19%) were from the axilla. All the MRSA isolates were resistant to ampicillin and penicillin, 93.8% were resistant to cotrimoxazole, 87.5% were resistant to both tetracycline and ceftriaxone, 68.8% were resistant to both ciprofloxacin and gentamicin, and 56.3% were resistant to clindamycin. Vancomycin was the most effective drug, with only 12.5% of MRSA isolates being resistant to it. Multidrug resistance was observed in 93.8% of the MRSA isolates.

Conclusion: The rate of MRSA carriage among CCU patients found in the present study was high and the majority of MRSA isolates were multidrug resistant. There is need to develop a sustainable policy on screening and decolonisation of MRSA on patients as they are admitted to CCUs to reduce the risk of infection in highly susceptible patients.