A THESIS SUBMITTED TO THE DEPARTMENT OF MEDICAL LABORATORY SCIENCE, COLLEGE OF MEDICINE AND HEALTH SCIENCES, ARBA MINCH UNIVERSITY, IN PARTIAL FULFILLMENT OF THE REQUIREMENTS OF THE DEGREE OF MASTER OF SCIENCE IN MEDICAL MICROBIOLOGY

Abstract

Background: Preoperative nasal colonization of Methicillin-Resistant Staphylococcus aureus is the major concern in Surgical Site Infections(SSIs) and makes treatment with common drugs worthless. Evidence on the prevalence and factors affecting preoperative colonization of MRSA is important for planning targeted infection control intervention, especially in developing countries like Ethiopia where information is scares. Objective: This study aimed to determine the prevalence of nasal colonization of MRSA, Antimicrobial susceptibility pattern, and associated factors among preoperative adult patients in Arba Minch General Hospital, Southern Ethiopia. Methods: An institution-based cross-sectional study was conducted from October, 2023 January, 2024. A total of 422 participants were selected by systematic random sampling technique. Socio-demographic data were collected using a pre-tested, semi-structured questionnaire. Nasal swabs were collected and S. aureus was identified following standard microbiological methods. MRSA was detected using a cefoxitin disc and the antimicrobial resistance profile of MRSA was detected using the Kirby Bauer disk diffusion on Muller Hinton Agar following Clinical and Laboratory Standards Institute(CLSI) 2023 guidelines. The data were analyzed using Statistical Package for the Social Sciences(SPSS) version 27. P-value <0.05 was considered statistically significant. Result: The prevalence of S. aureus and MRSA among preoperative patients was found to be 31.51% (133/422) with 95% CI: (26.5-35.8%) and 13.74%(58/422) with 95% CI: (10.4-17.3%) respectively. Of the MRSA isolates, 40(68.96%) were considered Multi-Drug Resistant(MDR). Age (50-59) (AOR =5.06; 95% CI: (1.79-14.32), Sex(male)(AOR = 0.336; 95% CI: (0.16-0.69), Hospitalization within the last year, (AOR = 2.29; 95% CI: (1.19-4.39), Diabetic mellitus. (AOR = 8.17; 95% CI: (3.87-17.26) and Current smoking (AOR = 0.16; 95% CI: (0.03-0.83) were found to have a significant association with MRSA colonization. Conclusion: Preoperative nasal colonization of MRSA among adult patients exceeded rates found in other studies. It is important to implement effective S. aureus and MRSA screening programs among preoperative adult patients by giving due emphasis on the identified associated factor