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Worku S, Abebe T, Seyoum B, Alemu A, Shimelash Y, Yimer M, Abdissa A, Beyene GT, Swedberg G, Mihret A. Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus among Patients Diagnosed with Surgical Site Infection at Four Hospitals in Ethiopia. Antibiotics (Basel) 2023; 12:1681. [PMID: 38136715 PMCID: PMC10741212 DOI: 10.3390/antibiotics12121681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of severe surgical site infections (SSI). The molecular epidemiology of MRSA is poorly documented in Ethiopia. This study is designed to determine the prevalence of MRSA and associated factors among patients diagnosed with SSI. A multicenter study was conducted at four hospitals in Ethiopia. A wound culture was performed among 752 SSI patients. This study isolated S. aureus and identified MRSA using standard bacteriology, Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS), and cefoxitin disk diffusion test. The genes mecA, femA, vanA, and vanB were detected through PCR tests. S. aureus was identified in 21.6% of participants, with 24.5% of these being methicillin-resistant Staphylococci and 0.6% showing vancomycin resistance. Using MALDI-TOF MS for the 40 methicillin-resistant Staphylococci, we confirmed that 31 (77.5%) were S. aureus, 6 (15%) were Mammaliicoccus sciuri, and the other 3 (2.5%) were Staphylococcus warneri, Staphylococcus epidermidis, and Staphylococcus haemolyticus. The gene mecA was detected from 27.5% (11/40) of Staphylococci through PCR. Only 36.4% (4/11) were detected in S. aureus, and no vanA or vanB genes were identified. Out of 11 mecA-gene-positive Staphylococci, 8 (72.7%) were detected in Debre Tabor Comprehensive Specialized Hospital. Methicillin-resistant staphylococcal infections were associated with the following risk factors: age ≥ 61 years, prolonged duration of hospital stay, and history of previous antibiotic use, p-values < 0.05. Hospitals should strengthen infection prevention and control strategies and start antimicrobial stewardship programs.
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Affiliation(s)
- Seble Worku
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa 1165, Ethiopia; (T.A.); (A.M.)
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor P.O. Box 272, Ethiopia
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa 1165, Ethiopia; (B.S.); (A.A.); (M.Y.); (A.A.); (G.T.B.)
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa 1165, Ethiopia; (T.A.); (A.M.)
| | - Berhanu Seyoum
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa 1165, Ethiopia; (B.S.); (A.A.); (M.Y.); (A.A.); (G.T.B.)
| | - Ashenafi Alemu
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa 1165, Ethiopia; (B.S.); (A.A.); (M.Y.); (A.A.); (G.T.B.)
| | - Yidenek Shimelash
- Debre Tabor Comprehensive Specialized Hospital, Debre Tabor P.O. Box 272, Ethiopia;
| | - Marechign Yimer
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa 1165, Ethiopia; (B.S.); (A.A.); (M.Y.); (A.A.); (G.T.B.)
| | - Alemseged Abdissa
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa 1165, Ethiopia; (B.S.); (A.A.); (M.Y.); (A.A.); (G.T.B.)
| | - Getachew Tesfaye Beyene
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa 1165, Ethiopia; (B.S.); (A.A.); (M.Y.); (A.A.); (G.T.B.)
| | - Göte Swedberg
- Department of Medical Biochemistry and Microbiology, Uppsala University, 750 08 Uppsala, Sweden;
| | - Adane Mihret
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa 1165, Ethiopia; (T.A.); (A.M.)
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa 1165, Ethiopia; (B.S.); (A.A.); (M.Y.); (A.A.); (G.T.B.)
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