Methicillin Resistant Staphylococcus aureus among HIV Infected Pediatric Patients in Northwest Ethiopia: Carriage Rates and Antibiotic Co-Resistance Profiles

Martha Tibebu Lemma; Yohannes Zenebe; Begna Tulu; Daniel Mekonnen; Zewdie Mekonnen

doi:10.1371/journal.pone.0137254

Methicillin Resistant Staphylococcus aureus among HIV Infected Pediatric Patients in Northwest Ethiopia: Carriage Rates and Antibiotic Co-Resistance Profiles

PLoS One. 2015 Sep 30;10(9):e0137254. doi: 10.1371/journal.pone.0137254. eCollection 2015.

Authors

Martha Tibebu Lemma¹, Yohannes Zenebe¹, Begna Tulu², Daniel Mekonnen², Zewdie Mekonnen³

Affiliations

¹ Department of Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
² Department of Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia.
³ Department of Biochemistry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia.

Abstract

Background: MRSA infections are becoming more prevalent throughout the HIV community. MRSA infections are a challenge to both physicians and patients due to limited choice of therapeutic options and increased cost of care.

Objectives: This study was aimed to determine the prevalence of colonization and co-resistance patterns of MRSA species among HIV positive pediatric patients in the Amhara National Regional State, Northwest Ethiopia.

Methods: Culture swabs were collected from the anterior nares, the skin and the perineum of 400 participants. In vitro antimicrobial susceptibility testing was done on Muller Hinton Agar by the Kirby-Bauer disk diffusion method, using 30 μg cefoxitin (OXOID, ENGLAND) according to the recommendations of the Clinical and Laboratory Standards Institute. Methicillin sensitivity/resistance was tested using cefoxitin. Data was analyzed by descriptive statistics and logistic regression model using Epi Info 7.

Results: S. aureus was detected in 206 participants (51.5%). The prevalence of MRSA colonization in this study was 16.8%. Colonization by S. aureus was associated with male gender (OR = 0.5869; 95% CI: 0.3812-0.9036; p-value = 0.0155), history of antibiotic use over the previous 3 months (OR = 2.3126; 95% CI: 1.0707-4.9948; p-value = 0.0329) and having CD4 T-cell counts of more than 350 x 10(6) cells / L (OR = 0.5739; 95% CI = 0.3343-0.9851; p-value = 0.0440). Colonization by MRSA was not associated with any one of the variables. Concomitant resistance of the MRSA to clindamycin, chloramphenicol, co-trimoxazole, ceftriaxone, erythromycin and tetracycline was 7.6%, 6%, 5.25%, 20.9%, 23.9% and 72.1%, respectively.

Conclusion: High rates of colonization by pathogenic MRSA strains is observed among HIV positive pediatric patients in the Amhara National Regional state.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
Child
Child, Preschool
Coinfection*
Drug Resistance, Bacterial
Ethiopia / epidemiology
Female
HIV Infections / drug therapy
HIV Infections / epidemiology*
HIV Infections / immunology
HIV-1* / drug effects
Humans
Male
Methicillin-Resistant Staphylococcus aureus* / drug effects
Prevalence
Staphylococcal Infections / epidemiology*

Grants and funding

This study was granted by the Research and Community Service Office of Bahir Dar University (http://www.bdu.edu.et/) under the watchful eye of the "Biotechnology Research Institute" of Bahir Dar University. MTL and YZC received the funding and submitted progress reports to the Biotechnology Institute as per the agreement.