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Antimicrob Resist Infect Control. 2014 Jul 15;3:22. doi: 10.1186/2047-2994-3-22. eCollection 2014.

Carriage of Staphylococcus aureus in Thika Level 5 Hospital, Kenya: a cross-sectional study.

Antimicrobial resistance and infection control

Alexander M Aiken, Irene M Mutuku, Artur J Sabat, Viktoria Akkerboom, Jonah Mwangi, J Anthony G Scott, Susan C Morpeth, Alexander W Friedrich, Hajo Grundmann

Affiliations

  1. London School of Hygiene and Tropical Medicine, Keppel Street, London, UK ; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
  2. Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
  3. Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  4. Thika Level 5 Hospital, Thika, Kenya.

PMID: 25057351 PMCID: PMC4107749 DOI: 10.1186/2047-2994-3-22

Abstract

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen but little is known about its circulation in hospitals in developing countries. We aimed to describe carriage of S.aureus amongst inpatients in a mid-sized Kenyan government hospital.

METHODS: We determined the frequency of S.aureus and MRSA carriage amongst inpatients in Thika Hospital, Kenya by means of repeated cross-sectional ward surveys. For all S.aureus isolates, we performed antibiotic susceptibility tests, genomic profiling using a DNA microarray and spa typing and MLST.

RESULTS: In this typical mid-sized Kenyan Government hospital, we performed 950 screens for current carriage of S.aureus amongst inpatients over a four month period. We detected S.aureus carriage (either MSSA or MRSA) in 8.9% (85/950; 95%CI 7.1-10.8) of inpatient screens, but patients with multiple screens were more likely have detection of carriage. MRSA carriage was rare amongst S.aureus strains carried by hospital inpatients - only 7.0% (6/86; 95%CI 1.5-12.5%) of all isolates were MRSA. Most MRSA (5/6) were obtained from burns patients with prolonged admissions, who only represented a small proportion of the inpatient population. All MRSA strains were of the same clone (MLST ST239; spa type t037) with concurrent resistance to multiple antibiotic classes. MSSA isolates were diverse and rarely expressed antibiotic resistance except against benzyl-penicillin and co-trimoxazole.

CONCLUSIONS: Although carriage rates for S.aureus and the MRSA prevalence in this Kenyan hospital were both low, burns patient were identified as a high risk group for carriage. The high frequency of genetically indistinguishable isolates suggests that there was local transmission of both MRSA and MSSA.

Keywords: Carriage prevalence; Hospitals; Kenya; MRSA; Staphylococcus aureus

References

  1. J Clin Microbiol. 2003 Dec;41(12):5442-8 - PubMed
  2. Clin Microbiol Infect. 2011 Apr;17(4):633-9 - PubMed
  3. J Clin Microbiol. 2000 Mar;38(3):1008-15 - PubMed
  4. J Clin Microbiol. 2009 Sep;47(9):2975-80 - PubMed
  5. Infect Genet Evol. 2009 Jan;9(1):32-47 - PubMed
  6. Clin Microbiol Infect. 2011 Feb;17(2):160-5 - PubMed
  7. Int J Antimicrob Agents. 2012 Sep;40(3):268-72 - PubMed
  8. BMJ. 2012 Apr 03;344:e1567 - PubMed
  9. PLoS One. 2011 Apr 06;6(4):e17936 - PubMed
  10. Burns. 1998 Mar;24(2):91-8 - PubMed
  11. J Glob Antimicrob Resist. 2013 Dec;1(4):189-193 - PubMed
  12. J Infect Dis. 1992 Jun;165(6):1064-8 - PubMed
  13. J Clin Microbiol. 2010 Dec;48(12):4608-11 - PubMed
  14. Infect Control Hosp Epidemiol. 2009 Aug;30(8):721-6 - PubMed
  15. Lancet Infect Dis. 2005 Aug;5(8):481-93 - PubMed
  16. PLoS One. 2013 Jul 23;8(7):e68721 - PubMed
  17. Epidemiol Infect. 2013 Aug;141(8):1717-20 - PubMed
  18. BMJ. 2002 Jun 8;324(7350):1365-6 - PubMed
  19. J Clin Microbiol. 2006 Feb;44(2):619-21 - PubMed
  20. Lancet. 2011 Jan 15;377(9761):228-41 - PubMed
  21. Lancet Infect Dis. 2005 Dec;5(12):751-62 - PubMed
  22. Burns. 2006 Aug;32(5):605-12 - PubMed
  23. Afr J Health Sci. 1995 Feb;2(1):232-235 - PubMed
  24. Lancet. 2011 Oct 8;378(9799):1291-2 - PubMed
  25. Neth J Med. 2001 Sep;59(3):126-33 - PubMed
  26. S Afr Med J. 2011 May;101(5):332-4 - PubMed
  27. Euro Surveill. 2008 May 08;13(19): - PubMed
  28. Int J Epidemiol. 2013 Oct;42(5):1502-8 - PubMed
  29. Clin Microbiol Infect. 2003 Feb;9(2):153-6 - PubMed

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