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尼日利亚一家三级医院儿童鼻腔耐甲氧西林定植的患病率及相关危险因素

The Prevalence and Risk Factors Associated with Nasal Methicillin-Resistant Colonization among Children in a Tertiary Hospital in Nigeria.

作者信息

Tuta Kemi Elizabeth, Okesola Abiola Olukemi, Umeokonkwo Chukwuma David

机构信息

University College Hospital, Ibadan, Oyo State, Nigeria.

Nigeria field Epidemiology laboratory Training Programme, Abuja, Nigeria.

出版信息

Ethiop J Health Sci. 2019 Jul;29(4):487-494. doi: 10.4314/ejhs.v29i4.10.

Abstract

BACKGROUND

Nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization is of public health concern due to increased risk of developing invasive infections and the therapeutic challenges. This concern is more among the vulnerable group. We determined the prevalence and associated risk factors of MRSA nasal carriage among children in a tertiary hospital in Nigeria.

METHOD

We conducted a hospital-based, cross-sectional study among 300 children attending the outpatient clinic of a tertiary hospital recruited through systematic sampling technique. An interviewer-administered, structured questionnaire was used to obtain sociodemographic characteristics and exposure factors. Nasal swabs samples were collected and inoculated on mannitol salt agar and subcultured on nutrient agar to isolate Staphylococcus aureus. We used the conventional Polymerase Chain Reaction (PCR) technique to detect the presence of mecA gene for MRSA. We calculated the prevalence, prevalence odds ratio to determine risk factors for MRSA acquisition at 5% level of significance.

RESULTS

The median age was 1.7 years (6 months-16 years). Males accounted for 60.7%, and 75% of the participants were under 5 years. Staphylococcus aureus colonization was found in 36.3% of the participants while 5.3% of the participants had MRSA identified by detecting the mecA gene. History of recent surgery in the last six months was the only independent predictor of nasal MRSA colonization among the participants (aOR=12.5; 95%CI: 2.7-50.0.).

CONCLUSION

The high prevalence of MRSA colonization observed among the children in this study suggests the need to consider screening children with history of previous surgery as infection control and prevention intervention for MRSA.

摘要

背景

耐甲氧西林金黄色葡萄球菌(MRSA)鼻腔定植因侵袭性感染风险增加及治疗挑战而备受公共卫生关注。这种关注在弱势群体中更为突出。我们确定了尼日利亚一家三级医院儿童中MRSA鼻腔携带的患病率及相关危险因素。

方法

我们采用系统抽样技术,对一家三级医院门诊的300名儿童进行了一项基于医院的横断面研究。通过访谈者实施的结构化问卷获取社会人口学特征和暴露因素。采集鼻拭子样本,接种于甘露醇盐琼脂上,并在营养琼脂上进行传代培养以分离金黄色葡萄球菌。我们使用传统聚合酶链反应(PCR)技术检测MRSA的mecA基因。我们计算患病率、患病率比值比,以确定在5%显著性水平下MRSA感染的危险因素。

结果

中位年龄为1.7岁(6个月至16岁)。男性占60.7%,75%的参与者年龄在5岁以下。36.3%的参与者发现有金黄色葡萄球菌定植,而通过检测mecA基因,5.3%的参与者被鉴定为MRSA。在过去六个月内近期手术史是参与者中鼻腔MRSA定植的唯一独立预测因素(调整后比值比=12.5;95%置信区间:2.7 - 50.0)。

结论

本研究中儿童中观察到的MRSA定植高患病率表明,有必要考虑对有既往手术史的儿童进行筛查,作为MRSA感染控制和预防干预措施。

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