Prevalence of MRSA and associated factors among wound patients at Werabe Comprehensive Specialized Hospital, Ethiopia

Abstract

Introduction: Staphylococcus aureus is a major global health threat due to its widespread distribution, ability to cause severe infections, and increasing antimicrobial resistance. It is responsible for a wide range of diseases, particularly skin and soft tissue infections, with wound infections being the most common. The emergence of methicillin-resistant S. aureus (MRSA) is of significant concern. However, local data on MRSA in wound infections remain limited. This study assessed the prevalence, antimicrobial susceptibility, and associated factors of MRSA among patients with wound infections at Werabe Comprehensive Specialized Hospital (WCSH).

Methodology: A cross-sectional study was conducted from July 2023 to February 2024 involving 384 patients with wound infections. Wound swabs or pus samples were cultured on blood agar and mannitol salt agar. Identification of S. aureus was performed using standard biochemical tests, while MRSA detection used the cefoxitin disk diffusion method following CLSI guidelines. Data were collected using a semi-structured questionnaire, entered into Epi-info, and analyzed with SPSS. Logistic regression identified associations, with p < 0.05 considered significant.

Results: Of 384 participants, 90 (23.4%) had S. aureus; of which 24 (26.7%) were MRSA. Most S. aureus isolates (87.8%) and all MRSA were resistant to penicillin but fully sensitive to linezolid. All MRSA and 31.1% of S. aureus isolates were multidrug resistant. Hospital stay > 72 hours was significantly associated with MRSA (AOR = 3.06, p = 0.031).

Conclusions: There is a notable prevalence of MRSA with high multidrug resistance. Strengthening infection control, antimicrobial stewardship, and reducing prolonged hospital stays are recommended.