CLINICAL EPIDEMIOLOGY OF NASAL COLONISATION WITH STAPHYLOCOCCUS AUREUS AMONG PAEDIATRIC INPATIENTS AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA.

Abstract

Background: Colonisation precedes Staphylococcus aureus (S. aureus) infections with associated high morbidity and mortality, especially in hospitalised patients. S. aureus is the second leading cause of Hospital Acquired Infections(HAI) and death from resistant infections among hospitalised patients. Information to guide useful strategies such as decolonization proved to control S. aureus infections is not available in this setting for paediatric in-patients. Aims and Objectives: The study aimed to determine the prevalence of S. aureus; to identify the social-demographic and clinical risk factors and the susceptibility pattern of S. aureus isolates colonising the nares of paediatric in-patients at the University College Hospital, Ibadan, Nigeria. Methodology: The study was cross-sectional, involving 385 paediatric in-patients aged less than 18 years. Nasal swab was taken from all patients within 48 hours of admission and analysed using conventional laboratory methods and the S. aureus isolates identified were further analysed using Analytical Profile Index for Staph (API Staph). Results: S. aureus carriage prevalence was 7.8% and Methicillin Resistant Staphylococcus aureus (MRSA) prevalence was 2.1%. Risk factors identified for S. aureus carriage were: skin lesions(p <0.001), eye discharge(p= 0.035), and allergy(p= 0.0038) with the absence of skin lesions protective of S. aureus carriage on multivariate analysis (OR=0.020; 95% C.I [0.007, 0.652]). S. aureus isolates showed good susceptibility to mupirocin(86.2%), clindamycin(79.3%) and cefoxitin(75.9%); fair susceptibility to genticin (65.5%) and poor susceptibility to cotrimoxazole(20.7%) and erythromycin(27.6%). Conclusion: S. aureus carriage in this setting is 7.8% with the absence of skin lesions being protective of S. aureus carriage. The isolates showed good sensitivity to locally available antibiotics.