*1Ukpai, E. G., and 2Onah, E. S.
1Department of Microbiology and Parasitology, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria
1International Institute of Infectious Diseases, Biosafety and Biosecurity Research, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria
2Department of Ophthalmology, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria
2Institute for Eye Health and Visual Science Research (IEHVSR), David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria *Correspondence to: ukpaieg@dufuhs.edu.ng
Abstract:
Background: Infection caused by methicillin-resistant Staphylococcus aureus (MRSA) remains a big health challenge around the world because it is associated with increase morbidity, mortality and healthcare costs. This study aimed to determine the prevalence and antibiotic susceptibility profiles of MRSA isolated from apparently healthy school pupils and students in Enugu and Ebonyi States, Nigeria.
Methodology: This was a descriptive cross-sectional study of apparently healthy pupils and students from the three Senatorial districts in each of Enugu and Ebonyi States, recruited by multi-stage random sampling technique. Urine and swab samples of nose, armpit and groin were collected from the participants and cultured for Staphylococcus aureus using standard microbiological methods. MRSA isolates were detected by the Kirby-Bauer disc diffusion method using cefoxitin 30µg disc. Statistical analysis of data was done using Chi-square and Fisher’s exact tests, and binary logistic regression analysis to compare the prevalence of S. aureus and MRSA with respect to gender, schools, senatorial districts, and States. P value less than 0.5 was considered statistical significance.
Results: A total of 441 participants were recruited with 234 (53.1%) males and 207 (46.9%) females. Samples of 206 (46.7%) participants yielded S. aureus, and 140 (31.7%) were confirmed as MRSA. Gender distribution showed comparable S. aureus colonization rate between males (47.0%, n=110) and females (46.4%, n=96), while the prevalence of MRSA colonization was higher in females (35.3%, n=73) than males (28.6%, n=67). Statespecific prevalence of MRSA colonization was 30.7% (n=71/231) in Enugu and 32.9% (n=69/210) in Ebonyi. There was no statistically significant association between MRSA colonization prevalence and sex (χ²=2.89, p=0.089) or State (χ²=0.46, p=0.50). However, prevalence of MRSA colonization was higher among secondary school students compared to primary school pupils, with borderline statistical significance (χ²=3.84, p=0.050). The overall antibiotic resistance profile of MRSA isolates revealed resistance rates ranging from 15.1% for gentamicin to 97.9% for penicillin.
Conclusion: This study reported high prevalence of MRSA colonization among apparently healthy pupils and students in both Enugu and Ebonyi States, southeast Nigeria. Government should strengthen infection prevention efforts in schools and enforce surveillance policies for antimicrobial resistance in the States. Antibiotics such as ciprofloxacin and gentamicin may still be effective for therapy of MRSA infections in the region.
Keywords: Prevalence, Antibiotic susceptibility, MRSA, Colonization, Pupils, Students
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