Carriage rate of nasal staphylococcus aureus and methicillin-resistant staphylococcus aureus and associated factors among diabetic patients at Tikur Anbessa Specialized Hospital Diabetic Clinic, Addis Ababa, Ethiopia
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Date
2020-02
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Addis Abeba University
Abstract
Background: Currently the prevalence of diabetes mellitus is increased alarmingly in low and
middle income countries. Concurrently the drug resistant S. aureus nasal carriage rate is
increasing that may serve as a source of further infections in Diabetes mellitus patients. There is
no study conducted on nasal carriage rate of S.aureus and Methicillin resistant S.aureus (MRSA)
among diabetes patients in Ethiopia.
Objective: The aim of this study was to assess the rate of nasal carriage of S.aureus and MRSA
and associated factors among diabetic patients at Tikur Anbessa Specialized Hospital Diabetic
Clinic, Addis Ababa, Ethiopia from January to June, 2018.
Methods: A cross-sectional study was conducted from January to June, 2018. A total of 422
diabetic patients were recruited at TASH Diabetic Clinic. Nasal swab from the anterior nares was
collected, and culture on both Manitol salt agar and blood agar. Antimicrobial susceptibility
testing was done using disc diffusion method on Muller Hinton agar. Susceptibility to methicillin
was phenotypically determined based on resistance of isolates to cefoxitin. Data was entered and
analyzed using SPSS software version 20. Binary logistic regression analysis was used to assess
the association of socio-demographic and associated factors for S.aureus culture isolates. P- value
< 0.05 was considered as statistically significant.
Results: The overall prevalence of S.aureus in the study was 47/422(11.1%). Majority of the S.
aureus isolates were resistant to penicillin 46(97.8) on the other hand, all of the S. aureus isolates
were sensitive to clindamycin. Multidrug resistance were shown in 4(6.2%) of the isolates. Of
these, one MRSA was isolated from retire man who had uncontrolled glucose level with Type II
DM despite insulin treatment and had foot wound. S.aureus isolation rate was significantly
higher among DM patients who currently used combination of insulin and oral drug for diabetes
mellitus treatment (odds ratio [AOR], 3.985, 95% CI, 1.270-12.437; p<0.017). None of the
assessed socio-demographic factors showed a significant association with S.aureus nasal
colonization.
Conclusion: The nasal carriage rate of S.aureus among DM patients was low in this study. Also,
the carriage rate of MRSA was very low in this study compared to other study; performing
culture and sensitivity test for those DM patients would reduce the complication of infection.
Further multicenter large scale studies should be conducted to identify the associated risk factors
and antibiotic resistance pattern in diabetes mellitus patients.
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Keywords
Staphylococcus aureus, MRSA, diabetes mellitus patients