ABSTRACT Back ground: Staphylococcus aureus is a gram positive bacteria that exists on the skin as nonnal flora. It is classified as Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-sensitive Staphylococcus aureus (MSSA), where MRSA is resistant to beta-lactam antibiotics. MRSA has become a predominant pathogen in the health care system causing outbreaks within the communities and hospitals. The infection risk of mortality and increases morbidity. Objective: To detennine the prevalence and antibiotic sensitivity pattems of methicillin-resistant Staphylococcus aureus in clinical samples at KID-teaching hospital, Ishaka Methods: This was a cross-sectional and descriptive study cmTied out for three months in the surgical ward. Patients admitted to the surgical ward with wound were included in the study after obtaining consent. Wound swabs were collected and taken to KIU-WC Microbiology laboratmy where culturing, identification of S. aureus, determination of MRSA using oxacilin and antibiotics susceptibility were performed. Results: Of 114 total isolates 75( 65.8%)were S.aureus isolates of which 64(85.3%) were coagulase. Of the coagulase-positive S .aureus 61(81.3%) were identified to be MRSA. All the MRSA isolates were resistant to e1ythromycin and susceptible to cloxacillin, ceftriaxone, and vancomycin and intermediate sensitivity were produced in reaction. Conclusion: This study showed the presence of Staphylococcus aureus was among two thirds of the patients in the surgical ward and a high percentage was resistant. The prevalence of MRSA was56.1% among the Staphylococcus aureus isolates. MRSA isolates were very sensitive to vancomycin, ceftriaxone and cloxacillin.

TABLE OF CONTENTS

DECLARATION ............................................................................................ II

DEDICATION ............................................................................................... .111

ACKNOWLEDGMENTS ............................................................................. IV

TABLE OF CONTENTS ............................................................................... V

LIST OF ABBREVIATIONS ........................................................................... VII

ABSTRACT .................................................................................................. VIII

CHAPTER ONE

1.1 INTRODUCTION .............................................................................. !

l.l.BACKGROUND .............................................................................. 1

1.2.PROBLEM STATEMENT .................................................................. 3

1.3.GENERAL OBJECTIVE ................................................................... 3

1.4.SPECIFIC OBJECTIVE ..................................................................... 3

1.5.HYPOTHESIS .................................................................................. 4

1.6. JUSTIFICATION OF STUDY .......................................................... .4

CHAPTER TWO

2.0 LITERATURE

REVIEW ..................................................................... 5

2.1 PREVALANCE OF MRSA ................................................................ 5

2.2 SPREAD OF MRSA ........................................................................ 5

2.3 IMPACT OF MRSA ........................................................................ 6

2.4 RISK FACTORS ............................................................................. 6

2.5 GENETIC FACTORS CONTRIBUTING TO THE RESISTANCE OF

S.aureus ... ...•.....................................•.........................................•.. 7

2.6 CONTROL OF MRSA ...................................................................... 9

CHAPTER THREE

3.0 METHODOLOGY

3.1 STUDY DESIGN ........................................................................... 11

3.2 STUDY SETTING .......................................................................... 11

3.3 STUDY POPULATION .................................................................. 11

v

3.4 SAMPLE SIZE ......•................................................................... 11

3.5 SAMPLING TECHNIQUES .............•....................................•...... 13

3.6 DATA COLLECTION PROCEDURES .......................................... 13

3.7 OUTCOME MEASURES ......•....................................................... 14

3.8 DATA ANALYSIS PROCEDURE ....................•............................. 14

3.9 ETHICAL CON SID ERA TIONS .......................•.............................. 14

3.10 LIMITATIONS TO THE STUDY ................................................... 15

CHAPTER FOUR

4.0 RESULTS •..................•.............................................................. 16

4.1 GROWTH OF MICROORGANISMS ............................................... 16

4.2 SUSCEPTIBILITY OF ISOLATES TO THE ANTIBIOTICS ....•........... 17

4.3 DISTRIBUTION OF MRSA AMONG PATIENTS .............................. 18

CHAPTER FIVE

5.0 DISCUSSION ................................••.......................................... 20

5.1 CONCLUSION .........•..............................•.................................. 21

5.2 RECOMMENDATION ....................•........................................... 21

CHAPTER SIX

6.0 REFRENCES ............................................................. 23

CHAPTER SEVEN

7.0 APPENDICES .............................................................•........... 28

7.1 LIST OF TABLES .................................................................... 28

7.2 LIST OF FIGURES ......................................•........................... 28

7.3 PHOTOS .........................................................................•...... 28