NASAL CARRIAGE AND ASSOCIATED FACTORS FOR METHICILLIN-RESISTANT STAPHMINCH, SOUTHERN ETHIOPIAYLOCOCCUS AUREUS AMONG MEDICINE AND HEALTH SCIENCE STUDENTS OF ARBA MINCH UNIVERSITY, ARB

Abstract

Background Medical students are more likely to nasally colonize by Methicillin-Resistant Staphylococcus aureus due to their frequent exposure to patients and harboring this pathogen as well as from the contaminated hospital environment. The nasal colonized individuals were at high risk of infections and can be served as a potential source of transmission Besides, MRSA with biofilm forming potency can develop multidrug resistance to the most currently available antimicrobials and subsequently complicate the treatment strategies. Objective: The aim of this study is to determine nasal carriage and associated factors for Methicillin-Resistant Staphylococcus aureus in medical and health science students of Arba Minch University, southern Ethiopia. Methods: An institution based cross-sectional study was conducted at AMU from August to November, 2020. A total of 258 participants were selected by systematic random sampling. Socio demographic data were collected using a pre tested, structured questionnaire. Nasal swabs were collected and S. aureus were identified following standard microbiological methods. Methicillin sensitivity/resistance was tested using cefoxitin disc and antimicrobial susceptibility testsperformed by Kirby-Bauer disc diffusion method. Biofilm forming ability was phenotypically detected by micro-titre plate assay. Descriptive statistics and binary logistic regression analysis were done by Statistical Package for the Social Sciences version 25. P <0.05 was considered statistically significant. Results: Overall prevalence of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus were 27.1% (70/258) and 7.4% (19/258) respectively. Methicillin-Resistant Staphylococcus aureus carriage was higher among medical intern, 16.9% (11/65). Isolates were resistant to antibiotics, such as trimethoprime-sulfamethaxazole (63.2%) and tetracycline (48.4%). Multidrug resistance was observed among 52.6% (10/19) of isolates. Besides, 31.4% (6/19) of Methicillin-Resistant Staphylococcus aureus were biofilm producers and all of them were MDR. Nose picking habit [(AOR=0.163, 95% CI: (0.030, 0.901)], sharing of clothing, sports equipment [(AOR=0.045, 95% CI: (0.008, 0.257)], dormitory [(AOR=0.81, 95% CI: (0.010, 0.658)] and way of hand decontamination [(AOR=0.027, 95% CI: (0.005, 0.163)] were statistically significant. Conclusion: Overall prevalence of nasal Methicillin-Resistant Staphylococcus aureus among students was comparatively lower than the other study done in Ethiopia. Alarmingly, 60% of MDR-MRSA was biofilm producers. Therefore, a regular laboratory-based surveillance, contact precautions and nasal decolonization to stop transmission are warranted. Keywords: Arba Minch, biofilm, MDR, MRSA, Nasal carriage, student