Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage among patients with diabetes at the Korle Bu Teaching Hospital
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS ONE
Abstract
To investigate the epidemiology of S. aureus and MRSA nasal carriage among people with
diabetes at the Korle Bu Teaching Hospital in Accra, including the prevalence, predictors of
carriage, and antibiotic resistance. This study was cross-sectional, involving 300 diabetes patients and 106 non-diabetic individuals.
Swab specimens of the nares were obtained from the participants and bacteriologically-
cultured. Identification and characterization of S. aureus and MRSA were based on
standard bacteriological methods; antimicrobial susceptibility testing was by the Kirby-
Bauer method.The prevalence of staphylococcal carriage, the diabetes group relative to the non-diabetes
group, were 31.0% and 10.4% (S. aureus), and 3.3% and 0.0% (MRSA). Presence of diabetes
predisposed to S. aureus carriage, but not MRSA nor coagulase-negative staphylococci
(CoNS) carriage (OR = 3.88; p < 0.0001). Colonization with CoNS was protective of S.
aureus (OR = 0.039, p < 0.001) and MRSA (OR = 0.115, p = 0.043) colonization among the
diabetics. The antimicrobial resistance patterns recorded among the S. aureus isolated from
the diabetic individuals relative to the non-diabetics were as follows: penicillin (95% vs.
91%), tetracycline (37% vs. 27%), cotrimoxazole (30% vs. 36%), erythromycin (17% vs.
0%), norfloxacin (13% vs. 0%), clindamycin (12% vs. 0%), gentamicin (9% vs. 0%), fusidic
acid (10% vs. 9%), linezolid (4% vs. 0%), and rifampicin (5% vs. 0%). The proportion of multidrug resistant S. aureus was 41% (n = 38) in the diabetes group and 0% in the non-diabetes
group; this difference was statistically significant (p = 0.01). The presence of diabetes predisposed the participants to S. aureus carriage by almost four
folds, but not MRSA carriage. Colonization with CoNS was protective of S. aureus and
MRSA carriage in the diabetes group. Finally, linezolid remains a good therapeutic agent for
anti-MRSA therapy.
Description
Research Article
Keywords
diabetes, Korle Bu Teaching Hospital, epidemiology of S. aureus and MRSA, antibiotic resistance, Swab specimens