Abstract:
Background: Environmental contamination with MRSA in routine medical care settings
poses an increased risk of health care associated infections through cross- transmission.
The cross-transmission is generally associated with healthcare-associated infections with
increased length of stays in hospitals, healthcare costs, and mortality. Less is reported on
both magnitudes and distribution of environment contamination by these pathogens in
hospitals in Tanzania.
Study Objective: To determine the magnitude and distribution of MRSA contamination
among various items in a patients’ care surroundings at Muhimbili National Hospital
(MNH).
Study Methodology: A cross sectional study was conducted where specimens from
various parts of patients’ care surroundings at MNH were processed for detection of MRSA
using MRSA selective agar. Antimicrobial resistance pattern of the confirmed MRSA
isolates was determined by Kirby Bauer disc diffusion method. Data was analyzed using
SPSS software version 20.0, p values of < 0.05 were considered statistically significant.
Results: A total of 200 samples from hospital environment were processed; the prevalence
of MRSA was 19.5 % with significantly higher prevalence in general wards. Patients’ beds
surfaces were the most contaminated among studied items (43.7%), whilst the surgical
trolleys were least contaminated (7.7%). Highest proportion of isolates were resistant to
Ampicillin (87.2%) where as none of the isolates were resistant to vancomycin. Ten (10) or
more patients in a room and specimen source were significant predictors for MRSA
contamination by bivariate logistic regression model.
Conclusion and recommendation: The reported high MRSA prevalence confirms that
areas of hospital environment present underestimated important reservoir for MDR
pathogens even in non outbreak settings. The findings provide the basis to emphasize on
the need to formulate hygiene protocols with special consideration on high touch surfaces,
Moreover larger prospective studies are recommended to assess the correlation between
environmental MRSA and the acquisition of MRSA by patients or the vice versa.
