Prevalence and correlates of MRSA and MSSA nasal carriage at a Ugandan regional referral hospital

Lisa M. Bebell, Arnold Ayebare, Yap Boum, Mark J. Siedner, Joel Bazira, Steven J. Schiff, Joshua P. Metlay, David Bangsberg, Stephen Ttendo, Paul G. Firth

Research output: Contribution to journalArticle

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Abstract

Background: Despite increasing antimicrobial resistance globally, data are lacking on prevalence and factors associated with Staphylococcus aureus (SA) and MRSA carriage in resource-limited settings.

Objectives: To determine the prevalence of SA and MRSA nasal carriage and factors associated with carriage among Ugandan regional referral hospital patients.

Methods: We enrolled a cross-section of 500 adults, sampling anterior nares for SA and MRSA carriage using Cepheid Xpert SA Nasal Complete.

Results: Mean age was 37 years; 321 (64%) were female and 166 (33%) were HIV infected. Overall, 316 (63%) reported risk factors for invasive SA infection; 368 (74%) reported current antibiotic use. SA was detected in 29% and MRSA in 2.8%. MRSA and MSSA carriers were less likely than SA non-carriers to be female (50% and 56% versus 68%, P  = 0.03) or to have recently used β-lactam antibiotics (43% and 65% versus 73%, P  = 0.01). MRSA carriers were more likely to have open wounds than MSSA carriers and SA non-carriers (71% versus 27% and 40%, P  = 0.001) and contact with pigs (21% versus 2% and 6%, P  = 0.008). MRSA carriage ranged from 0% of HIV clinic participants to 8% of inpatient surgical ward participants ( P  =   0.01). In multivariable logistic regression analysis, male sex was independently associated with SA carriage (OR 1.68, 95% CI 1.12-2.53, P  =   0.01) and recent β-lactam antibiotic use was associated with reduced odds of SA carriage (OR 0.61, 95% CI 0.38-0.97, P  =   0.04).

Conclusions: MRSA nasal carriage prevalence was low and associated with pig contact, open wounds and surgical ward admission, but not with HIV infection.

Original languageEnglish (US)
Pages (from-to)888-892
Number of pages5
JournalThe Journal of antimicrobial chemotherapy
Volume72
Issue number3
DOIs
StatePublished - Mar 1 2017
Externally publishedYes

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Methicillin-Resistant Staphylococcus aureus
Nose
Staphylococcus aureus
Referral and Consultation
Lactams
Anti-Bacterial Agents
Swine
HIV
HIV Infections
Inpatients
Logistic Models
Regression Analysis
Wounds and Injuries

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Bebell, L. M., Ayebare, A., Boum, Y., Siedner, M. J., Bazira, J., Schiff, S. J., ... Firth, P. G. (2017). Prevalence and correlates of MRSA and MSSA nasal carriage at a Ugandan regional referral hospital. The Journal of antimicrobial chemotherapy, 72(3), 888-892. https://doi.org/10.1093/jac/dkw472

Prevalence and correlates of MRSA and MSSA nasal carriage at a Ugandan regional referral hospital. / Bebell, Lisa M.; Ayebare, Arnold; Boum, Yap; Siedner, Mark J.; Bazira, Joel; Schiff, Steven J.; Metlay, Joshua P.; Bangsberg, David; Ttendo, Stephen; Firth, Paul G.

In: The Journal of antimicrobial chemotherapy, Vol. 72, No. 3, 01.03.2017, p. 888-892.

Research output: Contribution to journalArticle

Bebell, LM, Ayebare, A, Boum, Y, Siedner, MJ, Bazira, J, Schiff, SJ, Metlay, JP, Bangsberg, D, Ttendo, S & Firth, PG 2017, 'Prevalence and correlates of MRSA and MSSA nasal carriage at a Ugandan regional referral hospital', The Journal of antimicrobial chemotherapy, vol. 72, no. 3, pp. 888-892. https://doi.org/10.1093/jac/dkw472
Bebell, Lisa M. ; Ayebare, Arnold ; Boum, Yap ; Siedner, Mark J. ; Bazira, Joel ; Schiff, Steven J. ; Metlay, Joshua P. ; Bangsberg, David ; Ttendo, Stephen ; Firth, Paul G. / Prevalence and correlates of MRSA and MSSA nasal carriage at a Ugandan regional referral hospital. In: The Journal of antimicrobial chemotherapy. 2017 ; Vol. 72, No. 3. pp. 888-892.
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abstract = "Background: Despite increasing antimicrobial resistance globally, data are lacking on prevalence and factors associated with Staphylococcus aureus (SA) and MRSA carriage in resource-limited settings.Objectives: To determine the prevalence of SA and MRSA nasal carriage and factors associated with carriage among Ugandan regional referral hospital patients.Methods: We enrolled a cross-section of 500 adults, sampling anterior nares for SA and MRSA carriage using Cepheid Xpert SA Nasal Complete.Results: Mean age was 37 years; 321 (64{\%}) were female and 166 (33{\%}) were HIV infected. Overall, 316 (63{\%}) reported risk factors for invasive SA infection; 368 (74{\%}) reported current antibiotic use. SA was detected in 29{\%} and MRSA in 2.8{\%}. MRSA and MSSA carriers were less likely than SA non-carriers to be female (50{\%} and 56{\%} versus 68{\%}, P  = 0.03) or to have recently used β-lactam antibiotics (43{\%} and 65{\%} versus 73{\%}, P  = 0.01). MRSA carriers were more likely to have open wounds than MSSA carriers and SA non-carriers (71{\%} versus 27{\%} and 40{\%}, P  = 0.001) and contact with pigs (21{\%} versus 2{\%} and 6{\%}, P  = 0.008). MRSA carriage ranged from 0{\%} of HIV clinic participants to 8{\%} of inpatient surgical ward participants ( P  =   0.01). In multivariable logistic regression analysis, male sex was independently associated with SA carriage (OR 1.68, 95{\%} CI 1.12-2.53, P  =   0.01) and recent β-lactam antibiotic use was associated with reduced odds of SA carriage (OR 0.61, 95{\%} CI 0.38-0.97, P  =   0.04).Conclusions: MRSA nasal carriage prevalence was low and associated with pig contact, open wounds and surgical ward admission, but not with HIV infection.",
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AU - Bebell, Lisa M.

AU - Ayebare, Arnold

AU - Boum, Yap

AU - Siedner, Mark J.

AU - Bazira, Joel

AU - Schiff, Steven J.

AU - Metlay, Joshua P.

AU - Bangsberg, David

AU - Ttendo, Stephen

AU - Firth, Paul G.

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N2 - Background: Despite increasing antimicrobial resistance globally, data are lacking on prevalence and factors associated with Staphylococcus aureus (SA) and MRSA carriage in resource-limited settings.Objectives: To determine the prevalence of SA and MRSA nasal carriage and factors associated with carriage among Ugandan regional referral hospital patients.Methods: We enrolled a cross-section of 500 adults, sampling anterior nares for SA and MRSA carriage using Cepheid Xpert SA Nasal Complete.Results: Mean age was 37 years; 321 (64%) were female and 166 (33%) were HIV infected. Overall, 316 (63%) reported risk factors for invasive SA infection; 368 (74%) reported current antibiotic use. SA was detected in 29% and MRSA in 2.8%. MRSA and MSSA carriers were less likely than SA non-carriers to be female (50% and 56% versus 68%, P  = 0.03) or to have recently used β-lactam antibiotics (43% and 65% versus 73%, P  = 0.01). MRSA carriers were more likely to have open wounds than MSSA carriers and SA non-carriers (71% versus 27% and 40%, P  = 0.001) and contact with pigs (21% versus 2% and 6%, P  = 0.008). MRSA carriage ranged from 0% of HIV clinic participants to 8% of inpatient surgical ward participants ( P  =   0.01). In multivariable logistic regression analysis, male sex was independently associated with SA carriage (OR 1.68, 95% CI 1.12-2.53, P  =   0.01) and recent β-lactam antibiotic use was associated with reduced odds of SA carriage (OR 0.61, 95% CI 0.38-0.97, P  =   0.04).Conclusions: MRSA nasal carriage prevalence was low and associated with pig contact, open wounds and surgical ward admission, but not with HIV infection.

AB - Background: Despite increasing antimicrobial resistance globally, data are lacking on prevalence and factors associated with Staphylococcus aureus (SA) and MRSA carriage in resource-limited settings.Objectives: To determine the prevalence of SA and MRSA nasal carriage and factors associated with carriage among Ugandan regional referral hospital patients.Methods: We enrolled a cross-section of 500 adults, sampling anterior nares for SA and MRSA carriage using Cepheid Xpert SA Nasal Complete.Results: Mean age was 37 years; 321 (64%) were female and 166 (33%) were HIV infected. Overall, 316 (63%) reported risk factors for invasive SA infection; 368 (74%) reported current antibiotic use. SA was detected in 29% and MRSA in 2.8%. MRSA and MSSA carriers were less likely than SA non-carriers to be female (50% and 56% versus 68%, P  = 0.03) or to have recently used β-lactam antibiotics (43% and 65% versus 73%, P  = 0.01). MRSA carriers were more likely to have open wounds than MSSA carriers and SA non-carriers (71% versus 27% and 40%, P  = 0.001) and contact with pigs (21% versus 2% and 6%, P  = 0.008). MRSA carriage ranged from 0% of HIV clinic participants to 8% of inpatient surgical ward participants ( P  =   0.01). In multivariable logistic regression analysis, male sex was independently associated with SA carriage (OR 1.68, 95% CI 1.12-2.53, P  =   0.01) and recent β-lactam antibiotic use was associated with reduced odds of SA carriage (OR 0.61, 95% CI 0.38-0.97, P  =   0.04).Conclusions: MRSA nasal carriage prevalence was low and associated with pig contact, open wounds and surgical ward admission, but not with HIV infection.

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