title: Methicillin-resistant staphylococcus aureus (MRSA) colonization among Intensive Care Unit (ICU) patients and health care workers at Muhimbili national hospital, Dar Es Salaam, Tanzania, 2012.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) has been recognized as important nosocomial pathogens worldwide. S aureus may induce clinically manifested diseases, or the host may remain completely asymptomatic.
  
  
  METHODS
  A cross-sectional hospital-based study was conducted from October 2012 to March 2013 in two ICUs at MNH. Admitted patients and health care workers were enrolled in the study. Interviewer administered questionnaires; patient history forms, observation charts and case report forms were used to collect data. Swabs (nostrils, axillary or wounds) were collected. MRSA were screened and confirmed using cefoxitin, oxacillin discs and oxacillin screen agar. Antibiotic susceptibility was performed using Kirby-Bauer disk diffusion method. The risk factors for MRSA were determined using the logistic regression analysis and a p - value of <0.05 was considered as statistically significant.
  
  
  RESULTS
  Of the 169 patients and 47 health workers who were recruited, the mean age was 43.4 years ± SD 15.3 and 37.7 years ± (SD) 11.44 respectively. Among the patients male contributed 108 (63.9%) while in health worker majority 39(83%) were females. The prevalence of MRSA colonization among patients and health care workers was 11.83% and 2.1% respectively. All (21) MRSA isolates were highly resistant to penicillin and erythromycin, and 17 (85.7%) were highly sensitive to vancomycin. Being male (AOR 6.74, 95% CI 1.31-34.76), history of sickness in past year (AOR 4.89, 95% CI 1.82- 13.12), being sick for more 3 times (AOR 8.91, 95% CI 2.32-34.20), being diabetic (AOR 4.87, 95% CI 1.55-15.36) and illicit drug use (AOR 10.18, 95%CI 1.36-76.52) were found to be independently associated with MRSA colonization.
  
  
  CONCLUSIONS
  A study identified a high prevalence of MRSA colonization among patients admitted in the ICU. MRSA isolates were highly resistant to penicillin and erythromycin. History of illegal drug use was highly associated with MRSA colonization.
authors.affiliation: Tanzania Field Epidemiology and Laboratory Training Program, Dar Es Salaam, Tanzania.
authors.forename: Alfred
authors.initials: A
authors.lastname: Geofrey
authors.affiliation: Tanzania Field Epidemiology and Laboratory Training Program, Dar Es Salaam, Tanzania.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abade
authors.affiliation: Muhimbili University of Health and Allied Sciences (MUHAS), Dar Es Salaam, Tanzania.
authors.forename: Said
authors.initials: S
authors.lastname: Aboud
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: ICU; MRSA; colonization; prevalence