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Prevalence and risk factors of methicillin-resistant Staphylococcus aureus colonization among HIV patients in Mekelle, Northern Ethiopia

201639 citationsOpen accessMekelle University

In plain language

A cross-sectional investigation assessed the carriage rate and risk factors of methicillin-resistant Staphylococcus aureus colonization among 249 HIV-positive individuals across four health facilities in Mekelle, Northern Ethiopia. Nasal and throat swabs were evaluated using standard bacteriological procedures. Staphylococcus aureus was identified in 32.5 percent of the participants, with a confirmed methicillin-resistant colonization rate of 2.4 percent. Laboratory testing showed that all resistant isolates retained complete sensitivity to amikacin, whilst displaying varying resistance to erythromycin, clindamycin, ciprofloxacin, and trimethoprim-sulphamethoxazole. The analysis confirmed that a history of hospitalisation, the use of percutaneous devices, having a hospitalised household member, and an impaired immune status indicated by a low CD4 count were significantly associated with bacterial colonization.

Key takeaways

  • Staphylococcus aureus was detected in 32.5 percent of the surveyed HIV patients, with 2.4 percent colonized by methicillin-resistant strains.
  • All identified methicillin-resistant isolates showed complete susceptibility to amikacin.
  • Bacterial resistance was observed against erythromycin, clindamycin, ciprofloxacin, and trimethoprim-sulphamethoxazole.
  • Colonization was significantly linked to past hospital admissions, percutaneous device use, household hospital exposure, and CD4 counts below 200 cells per cubic millimetre.

Why it matters

People living with HIV are particularly vulnerable to secondary bacterial complications, making drug-resistant pathogens a serious clinical concern. Identifying local carriage rates and resistance profiles helps medical teams select effective antibiotics such as amikacin. Additionally, recognising specific risk factors, including low CD4 cell counts and recent healthcare exposure, enables healthcare providers to target preventive screening and manage vulnerable patients more effectively.

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Abstract

HIV-positive individuals are at higher risk of Methicillin Resistant Staphylococcus aureus (MRSA) colonization and its related infection. There is limited data in the nation on the prevalence and risk factors of MRSA colonization among HIV patients. The aim of this study was to address the existing knowledge gap. Cross sectional study was carried out from September 2014 to February 2015 in three selected health centers and one general hospital. A standardized questionnaire was developed for collection of socio-demographic and clinical data. A total of 498 Nasal and throat swabs (two for each patient) were collected from 249 patients, transported and processed using standard bacteriological procedures. Data was analyzed using Chi square (X 2 ) test and associated risk factors were determined. P < 0.05 was considered statistically significant. Out of 249 study participants, S. aureus was isolated from 81 (32.5 %) patients, with MRSA colonization rate of 6 (2.4 %). MRSA isolates were resistant to Ciprofloxacin and trimethoprim-sulphamethoxazole (16.7 % each), clindamycin (33.3 %) and erythromycin (50 %). However, all MRSA isolates were 100 % sensitive to Amikacin. History of hospitalization, percutaneous device usage, patients with a household member’s hospitalization and low CD 4 count (<200 cells/mm 3 ) were significantly associated with S. aureus colonization (p < 0.05).

Research topics

  • Antimicrobial Resistance in Staphylococcus
  • Antifungal resistance and susceptibility
  • Bacterial biofilms and quorum sensing

Sustainable Development Goals

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DOI: 10.1186/s40064-016-2613-7

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