Methicillin Resistant Staphylococcus Aureus from Patients Care Environment at Muhimbili National Hospital, Dar es Salaam

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.