Tamire Tewodros, Eticha Temesgen, Gelgelu Temesgen Bati
Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia.
Int J Microbiol. 2021 Oct 27;2021:9933926. doi: 10.1155/2021/9933926. eCollection 2021.
In healthcare facilities, a gradual increase in methicillin-resistant (MRSA) infections has been seen over the past 2 decades. Similarly, it has been responsible for the most frequent and invasive pathogens associated with admitted patient infection. Currently, it is considered an urgent threat to public health and classified as one of the top-priority antimicrobial-resistant pathogens. This study aimed to determine the magnitude and associated risk factors of MRSA infection among admitted patients.
A facility-based cross-sectional examination was led on 413 patients admitted to Tikur Anbessa Specialized Hospital from January 2018 to January 2019. A convenient sampling technique was used. Clinical specimens of pus and blood were collected from admitted patients who developed the infection after 48 hours of admission. Gram stain, culture media preparations, and biochemical tests were conducted to identify and isolate the causative agent. were identified as MRSA strains after having a zone of inhibition less than or equal to 21 mm to the cefoxitin (30 ug) disc. Bivariate and multivariable logistic regression analyses were computed. The odds ratio, along with 95% CI, was estimated to identify associated risk factors for MRSA infection.
Out of 413 collected specimens, 38.7% had coagulase-positive of which 35.6% (95% CI: 28.2%-43.0%) were MRSA. Being within the age group of 19-29 years and 30-39 years with AOR = 5.02 and 95% CI: 1.24-20.35 and AOR = 6.65 and 95% CI: 1.78-24.78, respectively, admitting in the hematology ward and the pediatric ward with AOR = 7.80 and 95% CI: 1.82-33.49 and AOR = 10.54 and 95% CI: 1.78-62.42, respectively, and experiencing poor prognosis with AOR = 10.97 and 95% CI: 4.57-26.36 were significantly associated with MRSA infection. The significant magnitude of MRSA was found among patients admitted to this hospital. Therefore, identified risk factors should be considered when executing hospital-acquired infection prevention programs. We also suggest that healthcare providers should consider the identified risk factors while prescribing the antibiotic.
在医疗机构中，耐甲氧西林金黄色葡萄球菌（MRSA）感染在过去20年中呈逐渐上升趋势。同样，它也是与住院患者感染相关的最常见且具有侵袭性的病原体。目前，它被视为对公众健康的紧迫威胁，并被列为最优先的抗菌药物耐药病原体之一。本研究旨在确定住院患者中MRSA感染的严重程度及相关危险因素。
对2018年1月至2019年1月入住提库尔·安贝萨专科医院的413例患者进行了基于机构的横断面调查。采用了方便抽样技术。从入院48小时后发生感染的住院患者中采集脓液和血液的临床标本。进行革兰氏染色、培养基制备和生化试验以鉴定和分离病原体。对头孢西丁（30μg）纸片抑菌圈直径小于或等于21mm的菌株鉴定为MRSA菌株。进行了二元和多变量逻辑回归分析。计算比值比及95%置信区间，以确定MRSA感染的相关危险因素。
在413份采集的标本中，38.7%为凝固酶阳性，其中35.6%（95%置信区间：28.2%-43.0%）为MRSA。年龄在19-29岁和30-39岁组，调整后比值比分别为5.02，95%置信区间：1.24-20.35和6.65，95%置信区间：1.78-24.78；入住血液科病房和儿科病房，调整后比值比分别为7.80，95%置信区间：1.82-33.49和10.54，95%置信区间：1.78-62.42；预后不良，调整后比值比为10.97，95%置信区间：4.57-26.36，均与MRSA感染显著相关。在该医院住院的患者中发现了显著的MRSA感染情况。因此，在实施医院获得性感染预防计划时应考虑已确定的危险因素。我们还建议医疗服务提供者在开具抗生素时应考虑已确定的危险因素。
