Archives of Public Health | |
Isolation and antimicrobial susceptibility pattern of Staphylococcus aureus in patients with surgical site infection at Debre Markos Referral Hospital, Amhara Region, Ethiopia | |
Amlsha Kahsay1  Adane Mihret3  Tamrat Abebe4  Tebkew Andualem2  | |
[1] School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia | |
[2] Debre Markos Referral Hospital, Debre Markos, Ethiopia | |
[3] Armauer Hansen Research Institute, Addis Ababa, Ethiopia | |
[4] Department of Biochemistry, WHO Immunology Research and Training Center, University of Lausanne, Lausanne, Switzerland | |
关键词: Antibiotic susceptibility; Prevalence; Surgical site infection; MRSA; S. aureus; | |
Others : 790449 DOI : 10.1186/2049-3258-72-16 |
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received in 2013-08-02, accepted in 2014-02-28, 发布年份 2014 | |
【 摘 要 】
Background
Staphylococcus aureus, especially Methicillin Resistant Staphylococcus Aureus (MRSA) is a major health problem recognized as the most important nosocomial pathogen, often causing postoperative wound infections. Antibiotic resistance by MRSA has grown to be common, and resistance to almost all antibiotics has been found among these strains. The aim of this study was to determine the prevalence, antimicrobial susceptibility patterns and associated risk factors of S. aureus in patients with surgical site infections in an Ethiopian hospital.
Methods
A cross-sectional study was conducted from December 1, 2011 to March 30, 2012 among patients with surgical site infections at Debre Markos Referral Hospital, Debre Markos, Ethiopia. All wound swabs obtained from patients with surgical site infections during the study period were cultured on mannitol salt agar media which is selective for S. aureus. Isolated strains of S. aureus were tested for antibiotic susceptibility patterns using standard disc diffusion technique, and interpretation of resistance was done based on Clinical and Laboratory Standard Institute criteria. Univariate and multivariable analyses were used to assess the risk factors.
Results
Of the 184 surgical patients who had developed surgical site infection, S. aureus was isolated from 73 (39.7%) cases. Out of the 73 isolates of S. aureus, 36 (49.7%) were MRSA. Among the study participants, prevalence of MRSA was found to be 19.6%. The clinical isolates showed >80% level of resistance to ampicillin, amoxicillin, penicillin G, erythromycin, gentamicin and cotrimoxazole whereas <50% level of resistance was observed against clindamycin, oxacillin, tetracycline and vancomycin. MRSA strains showed resistance ranging from 5.6% (vancomycin) to 100% (cotrimoxazole). Of the following risk factors: sex, age, pus consistency, duration of operation, type of surgery, ward and hospital stay, laparotomy type of surgery was identified as a risk factor for infection by S. aureus.
Conclusion
The prevalence of S. aureus and/or MRSA infection in surgical and gynaecology & obstetrics wards of Debre Markos Referral Hospital was found to be high. The majority of isolates were highly resistant to major antimicrobial agents.
【 授权许可】
2014 Kahsay et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20140705000543634.pdf | 240KB | download | |
Figure 1. | 24KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Marshalla C, Wesselinghb S, McDonaldc M, Spelmand D: Control of endemic MRSA-what is the evidence? a personal view. J Hosp Infect 2004, 56(4):253-268.
- [2]Barie PS, Nichols RL, Wilson SE: Surgical site infections in the era of antimicrobial resistance. Infect Dis 2006, 9:4-7.
- [3]Guyot A, Layer G: MRSA ‘bug-bear’ of a surgical practice: reducing the incidence of MRSA surgical site infections. Ann R Coll Surg Engl 2006, 88:222-223.
- [4]Communicable Disease Control (CDC): Management of Multidrug-Resistant Organisms in Healthcare Settings. USA: Department of Health and Human Services; 2006:7-53.
- [5]Wasserman E, Taljaard J: Update on infections caused by Staphylococcus aureus. South Afr J Epidemiol Infect 2011, 26(2):60-64.
- [6]Jonson AP: Intermediate vancomycin resistance in S. Aureus: a major threat or a minor inconvenience. J Antimicrob Chemother 1998, 42:289-291.
- [7]Fraise AP: Guidelines for the control of methicillin resistant S. aureus. J Antimicrob Chemother 1998, 42:287-289.
- [8]Alexander JW, Solomkin JS, Edwards MJ: Updated recommendations for control of surgical site infections. Ann Surg 2011, 253(6):1082-1093.
- [9]Clinical and Laboratory Standard Institute (CLSI): Performance standards for antimicrobial susceptibility testing twentieth informational supplement. M100-S20 2010, 30(1):60-73.
- [10]Olszewski MA, Falkowski NR, Surana R, Sonstein J, Hartman A, Moore BB, Huffnagle GB, Toews GB: Effect of laparotomy on clearance and cytokine induction in Staphylococcus aureus-infected lungs. Am J Respir Crit Care Med 2007, 176(9):921-929.
- [11]Amare B, Abdurrahman Z, Moges B, Ali J, Muluken L, Alemayehu M, Yifru S, Sendek B, Belyhun Y, Moges F, Kassu A: Postoperative surgical site bacterial infections and drug susceptibility patterns at Gondar university teaching hospital, northwest Ethiopia. J Bacteriol Parasitol 2011, 2(8):126.
- [12]Naik G, Deshpande S: A study on surgical site infections caused by Staphylococcus aureus with a special search for methicillin-resistant isolates. J Clin Diagn Res 2011, 5(3):502-508.
- [13]Akpaka PE, Kissoon S, Swanston WH, Monteil M: Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus isolates from Trinidad & Tobago. Ann Clin Microbiol Antimicrob 2006, 5:16. BioMed Central Full Text
- [14]Zoumalan RA, Rosenberg DB: Methicillin resistant Staphylococcus aureus positive surgical site infections in face-lift surgery. Arch facial plast surg 2008, 10(2):116-123.
- [15]Hussain S, Shams R, Ahmad K, Perveen R, Riaz B: Prevalence of methicillin resistant Staphylococcus aureus (MRSA) in surgical site infections in a tertiary care hospital. Journal Pathol 2005, 3(2):81-85.
- [16]Debdas D, Joshi S: Incidence of clindamycin resistance in clinical isolates of Staphylococcus aureus. J Infect Dev Ctries 2011, 5(4):316-317.
- [17]Arora S, Devi P, Arora U, Devi B: Prevalence of methicillin resistant Staphylococcus aureus (MRSA) in a tertiary care hospital in northern India. J Lab physicians 2010, 2(2):78-81.