title: High nasal carriage of methicillin-resistant Staphylococcus aureus among healthy Tanzanian under-5 children.
abstract: This study aimed to determine the prevalence of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) carriage, risk factors of colonization and antimicrobial susceptibility patterns of S. aureus strains. The study was conducted at the Muhimbili National Hospital in Dar es Salaam, Tanzania. Nasal swabs were obtained from children and S. aureus was isolated and identified using conventional culture methods. MRSA was screened and confirmed using the cefoxitin disk and multiplex real-time polymerase chain reaction, respectively. Antibiotic susceptibility was performed using the Kirby-Bauer disk diffusion method. MRSA isolates were further characterized by pulsed field gel electrophoresis (PFGE) profiling. Of 285 children included in the study, S. aureus was detected in 114 (40%). Of the 114 isolates, 12 (10.5%) were MRSA. PFGE results showed that these MRSA isolates are epidemiologically unrelated. Resistance of all S. aureus to trimethoprim-sulfamethoxazole, tetracycline, gentamicin, and ciprofloxacin was 65.8%, 23.7%, 27.2%, and 4.4%, respectively. No resistance to vancomycin was found. The prevalence of inducible clindamycin resistance, constitutive clindamycin resistance, MS phenotype (resistance to erythromycin alone), and multidrug resistance was 16.7%, 1.8%, 14.0%, and 16.8%, respectively. None of the risk factors examined was found to be significant. This is the first report of S. aureus and nasal carriage of MRSA and a high rate of S. aureus carriage was found in Tanzanian under-5 children. The study findings support the need for proper health education and effective infection control measures for healthcare workers.
authors.affiliation: 1 Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences (MUHAS) , Dar es Salaam, Tanzania .
authors.forename: Sabrina John
authors.initials: SJ
authors.lastname: Moyo
authors.forename: Said
authors.initials: S
authors.lastname: Aboud
authors.forename: Bjorn
authors.initials: B
authors.lastname: Blomberg
authors.forename: Namala
authors.initials: N
authors.lastname: Mkopi
authors.forename: Mabula
authors.initials: M
authors.lastname: Kasubi
authors.forename: Karim
authors.initials: K
authors.lastname: Manji
authors.forename: Eligius F
authors.initials: EF
authors.lastname: Lyamuya
authors.forename: Samuel Y
authors.initials: SY
authors.lastname: Maselle
authors.forename: Nina
authors.initials: N
authors.lastname: Langeland
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D002440:Cefoxitin / Q000494:pharmacology; D002675:Child, Preschool; D002999:Clone Cells; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D009296:Nasal Cavity / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D013636:Tanzania / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D002440:Cefoxitin