Abstract :

Background: Lower respiratory tract infection (LRTIs) is an emerging and threatening disease of both adults and children.  Methicillin resistant Staphylococcus aureus (MRSA) remains a life threatening pathogens that may colonize the lungs and cause Staphylococcal related lower respiratory tract infection. The aim of this study was to determine the prevalence and risk factors associated with MRSA infection among individuals with lower respiratory tract infections in a community setting.

Method: A structured questionnaire consisting of demographic characteristics, antibiotic usage, social life habits were administered to 152 participants, comprising of 80 males and 72 females. The subjects were selected based on non- hospitalization for the past six months. Sputum samples were collected and cultured unto Mannitol Salt agar. The Staphylococcus aureus isolates were sub-cultured unto Chromagar MRSA for MRSA identification. The isolates were subjected to antibiotic susceptibility testing, using disc diffusion method.

Result: The MRSA were highly resistant to Ampiclox (96.2%), Amoxcillin (92.3%), Rifampicin and Streptomycin (80.8%), Norfloxacin (76.9%), Erythromycin and Chroramphenicol (69.2%), and Levofloxacin (65.4%).

Conclusion: This study showed that MRSA is implicated in LRTIs and is brought about by improper therapy and lack of awareness.

---

Keywords :

Methicillin resistant Staphylococcus aureus, Respiratory tract infection.

---

References :

1. Serawit .D, Sintayehu .Fand Ayalew .A.  Resistance      of Staphylococcus aureus to antimicrobial agents in Ethiopia.                    Antimicrobial Resistance & Infection Control. 2017; 85(6): 852-857.
2. David Z. Michael and Daum S. Robert. Community associated methicillin resistant Staphylococcus aureus: Epidemiology and clinical manifestation of an emerging epidemic Clinical Microbiology Review. 2010; 616-687.
3. International working group on the classification of Staphylococcal cassette chromosome elements (IWG-SCC). Classification of Sccmec: Guidelines for reporting novel Sccmec elements. Antimicrobial Agents and Chemotheraphy. 2009; 53:4961-4967.
4. Shu-Hua Wang, Lisa Hines, Joany van Balen, José R Mediavilla, Xueliang Pan, Armando E. Hoet, Barry N                   Kreiswirth, Preeti Pancholi, Kurt B Stevenson.  Molecular and clinical characteristics of hospital and community onset methicillin-resistant Staphylococcus aureus strains associated with bloodstream infections. Journal of Clinical Microbiology. 2015; 53(5):1599-608.
5. Ping Mao, Ping Peng, Zhiyong Liu, Zhenrui Xue, Chunyan Yao. Risk factors and clinical outcomes of Hospital-Acquired MRSA infections in Chongquig, China Infection and Drug Resistance. 2019; 12: 3709-3717.
6. Danzmann L, Gastmeier P, Schwab F, Vonberg RP. Health care workers causing large nosocomial outbreaks: a systematic BMC Infectious Disease. 2013; 3(1):98.
7. Tong SY, Davis JS, Eichenberger E, Holland TL, Fowler VG Jr. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clinical Microbiol. Review. 2015; 28(3):603–61.
8. Jun-Hua Liang, Yu-Wei Fang, An-Hung Yang and Ming Hsien Tsai, Devastating renal outcome caused by skin infection with methicillin-resistant Staphylococcus aureus Medicine. 2016; 95(26): 4023.
9. Upreti N, Rayamajhee B, Sherchan SP, Choudhari MK, Banjara MR. Prevalence of methicillin resistant Staphylococcus aureus, multidrug resistant and extended spectrum β-lactamase producing gram negative bacilli causing wound infections at a tertiary care hospital of Nepal. Antimicrobial Resistant Infection Control. 2018; 7(1):121.
10. Sabbagh P, Riahi SM, Gamble HR, Rostami A. The global and regional prevalence, burden, and risk factors for methicillin-resistant Staphylococcus aureus colonization in HIV patients. American Journal Infection Control. 2019; 47(3):323-333.
11. Center for Disease Control and Prevention Guidelines for infection control in healthcare personnel. 2010; www.cdc.gov/hicpac /pdf/..
12. Udobi, E. Obajuluwa, A. F and Onaolapo J. A.  Prevalence and Antibiotic Resistance Pattern of Methicillin Resistant Staphylococcus aureus from an Orthopaedic Hospital in Nigeria. BioMed Research International. 2013; 14 (9): 45.
13. Köck R, Becker K, Cookson B, van Gemert-Pijnen JE, Harbarth S,Kluytmans J.Methicillin-resistant Staphylococcus aureus (MRSA): burden of disease and control challenges in European Surveillance. 2010; 15(41):19688.
14. Lakhundi S, and Zhang K. Methicillin-Resistant Staphylococcus aureus: Molecular Characterization, Evolution and Epidemiology. Clinical Microbiol.Review.2018; 31(4) [PubMed].
15. Richard P, Evans MD. The Silent Epidemic. Ca-MRSA and Ha- American Academy of Orthopedic Surgeons. (AAOS). 2011; 5(7).
16. Monecke, S. Coombs,G. Shore A. C. et al., “A field guide to pandemic, epidemic and sporadic clones of methicillin-resistant Staphylococcus aureus,” PLoS ONE. 2013; 6(4).
17. Udo EE, Boswihi SS. Antibiotic resistance trends in methicillin- resistant Staphylococcus aureus isolated in Kuwait hospitals: 2011–2015. Medical Principle Practice. 2017; 26(5):485–90.
18. Nagham Khanafer, Nicolas Sicot, Philippe Vanhems, Oana Dumitrescu. Severe leukopenia in Staphylococcus aureus-necrotizing, community-acquired pneumonia: risk factors and impact on survival. BMC Infectious Diseases. 2013; vol.13: 359.
19. Monika Pomorska-Wesołowska, Anna Różańska, Joanna Natkaniec, Barbara Gryglewska, Anna Szczypta, Mirosława Dzikowska, Agnieszka Chmielarczyk and Jadwiga Wójkowska-Mach. Longevity and gender as the risk factors of methicillin-resistant Staphylococcus aureus infections in Southern Poland.BMC Geriatr 2017;    17:15-21.
20. David H Wyllie, A Sarah Walker, Ruth Miller, Catrin Moore, Susan Williamson, Iryna Schlackow, John M Finney, Lily O’Connor, Tim E A Peto, Derrick Crook. Decline of methicillin resistant Staphylococcus aureus in Oxfordshire hospitals is strain-specific and preceded infection-control intensification. BMJ journal of infectious diseases. 2011;1, (I).
21. Okon, K.O, Basset A. Uba, P. Oyawoye, O. M, Yusuf, I. Z, Shihu A.O and Lin J. Blane Epidemiology and Characteristic pattern of MRSA  Recovered from Tertiary Hospital in Northeastern Nigeria. International Journal of Tropical medicine. 2011; 6(5):106-112.
22. Usman Abubakar and Syed A.S.Sulaiman. Prevalence, trend and antimicrobial susceptibility of Methicillin Resistant Staphylococcus aureusin Nigeria: Journal of Infection and  Public Health. 2018; 11(6):763-770.
23. Naves, K. S. C. Trindade, N. V. d and Gontijo Filho, P. P.Methicillin-resistant Staphylococcus aureusbloodstream infection: risk factors and clinical outcome in non-intensive-care units,” Revista da Sociedade Brasileira de Medicina 2012; 45,(2):189–193.
24. Weber S.G, Gold H.S, Hooper D.C, Karchmer AW and Yehuda Carmel Fluroroquinolone and the risk for Methicillin resistant Staphylococcus aureus in Hospitalised Patients. Emerging infectious Diseases. 2003; cdc.gov/eid. vol 9:11