Nasal carriage of methicillin resistant Staphylococcus aureus among medical students of a private institution in Ilishan-Remo, Ogun State, Nigeria

*1Ajani, T. A., 1Elikwu C. J., 1Nwadike, V., 1Babatunde, T., 2Anaedobe, C. J., 1Shonekan, O., 1Okangba, C. C., 1Omeonu, A., 1Faluyi, B., 1Thompson, T. E., 1Ebeigbe, E., 3Eze, B. G., 4Ajani, M. A., 1Perelade, K., 1Amoran, M., 1Okisor, P., 1Worancha, T., 1Ayoade, J.,
1Agbeniga, E., 1Emmanuel, C., and 1Coker, C. A.

1Department of Medical Microbiology, Ben Carson School of Medicine/Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria

2Department of Medical Microbiology, University of Abuja, Federal Capital territory, Abuja, Nigeria

3Department of Histopathology, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria

4Department of Histopathology, College of Medicine/University College Hospital, Ibadan, Oyo State, Nigeria *Correspondence to:; +2348034412609


Background: Nasal carriage of methicillin resistant Staphylococcus aureus (MRSA) is a major factor for its transmission especially from the health workers and medical students to their patients. There are a number of published data on the prevalence of MRSA among health workers but data on nasal colonization of medical students by MRSA are sparse in Nigeria. The objectives of this study are to determine the prevalence of nasal carriage of MRSA among medical students of the Ben Carson School of Medicine, Babcock University, Ilishan-Remo, Ogun State, Nigeria, and identify risk factors associated with this nasal carriage.

Methodology: A case control study involving 100 clinical (study group) and 100 pre- clinical (control group) medical students was undertaken between March 2018 and October 2019. Structured questionnaire was administered to obtain socio-demographic information and potential risk factors. Nasal swab was collected from each student and cultured for isolation of S. aureus by standard microbiology techniques. Phenotypic MRSA was detected by the cefoxitin 30μg disk diffusion method according to the guideline of Clinical and Laboratory Standards Institute. The mecA gene was detected by conventional polymerase chain reaction (PCR) assay.

Results: The prevalence of S. aureus nasal carriage among the study group was 14% (14/100) while the prevalence among the control group was 6% (6/100) (p=0.097). The prevalence of phenotypic MRSA among the study group was 4% (4/100) and 1% (1/100) among the control group (p=0.3687) while mecA gene was detected in 3 of the 4 (75%) phenotypic MRSA positive study participants and in the only (100%) phenotypic MRSA positive (1%) control group. Antibiotics usage without prescription, antibiotic treatment of common cold, and use of antibiotics in the previous one year, were significantly associated with MRSA carriage among the study group.

Conclusion: Although the prevalence of nasal carriage of S. aureus and MRSA among clinical and pre-clinical medical students was not statistically significant, the risk factors identified with carriage of MRSA among the study group indicates the need for antimicrobial stewardship program to reduce carriage and transmission of MRSA by medical students.

Keywords: methicillin resistant, Staphylococcus aureus, mecA gene, nasal carriage, medical students

Received March 25, 2020; Revised April 27, 2020; Accepted April 28, 2020 Copyright 2020 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License <a rel=”license” href=”//”, which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

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SS Taiwo, BA Onile, AA Akanbi II



Nosocomial infections caused by methicillin-resistant strains of Staphylococcus aureus often pose therapeutic dilemma to the clinicians because of the multi resistant nature of these strains of Staphylococcus aureus. Outbreaks of both nosocomial and community acquired infections are also frequent and difficult to control. This study determined the prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) at the University of Ilorin Teaching Hospital, between January and December 2001. The methicillin disc diffusion method for the detection of methicillin resistance and the Kirby-Bauer disc diffusion for antibiotic susceptibility tests, were used. The MRSA prevalence rate was 34.7% (51/147) of all Staphylococcus aureus isolates. Forty-five isolates were associated with infections and 6 were colonizing strains. Thirty-six (70.6%) were hospital (nosocomial) acquired while 15 (29.4%) were community-acquired. Forty-eight patients have received antibiotics previously including 30 who had received multiple antibiotics. Skin and soft tissues were sites of infections in 36 cases and surgical, emergency and intensive care units accounted for 31 isolates. All MRSA isolates were resistant to more than two antibiotics but remained largely susceptible to third generation cephalosporins, macrolides and quinolones and all were sensitive to vancomycin. We recommend the use of third generation cephalosporins and quinolones where indicated, in the treatment of serious MRSA infections in this environment. Control of the spread of MRSA in this hospital must include reinforcement of appropriate use of antibiotics, hand washing and laboratory surveillance for MRSA, particularly in the surgical wards and intensive care units, in order to identify sources of outbreaks.

Key Words: Methicillin-resistant, Staphylococcus aureus, Ilorin.

Afr. J. Clin. Exper. Microbiol. 2004; 5(2): 189 – 197.


B.O. Olayinka, A.T. Olayinka



The study assessed the importance of Staphylococcus aureus as a urinary pathogen and the incidence of multidrug resistant (MDR), methicillin-resistant Staphylococcus aureus (MRSA). A total of 86 staphylococcal isolates made up of 50 clinical isolates from urine samples submitted to the Medical Microbiology Laboratory of Ahmadu Bello University Teaching Hospital and 36 asymptomatic bacteriuria isolates from urine samples of ‘healthy’ volunteers within the university community were tested for their susceptibility to various antibiotics and production of b-lactamase enzyme. A total of 27 isolates (31.4%) were methicillin resistant, with 12(44.4%) being methicillin resistant coagulase-negative staphylococci (MRCNS). Majority of the isolates tested were resistant to the cheap, readily available broad-spectrum antibiotics; ampicillin, amoxicillin, chloramphenicol, tetracycline and penicillin G. All the isolates were resistant to three or more of the antimicrobial agents tested. A total of 14/50 (28%) of the clinical isolates and 17/36 (47.2%) of the ‘community’ isolates from healthy volunteers were resistant to 7 or more of the antimicrobial agents tested. Analysis of the multiple antibiotic resistance (MAR) index of isolates and the production of b-lactamase enzyme showed that 56 isolates representing 65.1% of the total number tested had an MAR index of 0.5 and above indicating that they probably originated from an environment where antibiotics are frequently used. The implication of these findings for instituting effective control measures aimed at reducing the pool of antibiotic-resistant organisms is discussed.

Key words: Methicillin-resistant, staphylococcus aureus, asymptomatic bacteriuria, infection control
(Af J Clinical & Exp Microbiology: 2003 4(2): 79-90)