Methicillin Resistant Staphylococcus aureus among HIV positive Pediatric Patients in Northwest Ethiopia: By GenoType MRSA Molecular Line Probe Assay

Yohannes Zenebe^{1, 2*} (yohabt22@gmail.com), Martha Tibebu^1,2(marthatib@yahoo.com), Begna Tulu^{1,2 (}begna.tulu@yahoo.com), Daniel Mekonnen^1,2 (nigusdaniel@gmail.com), Zewdie Mekonnen^2,3, (zewdmek28@yahoo.com)

¹Bahir Dar University, College of Medicine and Health Sciences, Department of Medical Microbiology, Immunology and Parasitology, Bahir Dar, Ethiopia..

²Bahir Dar University,Biotechnology Research Institute, Bahir Dar, Ethiopia.

³Bahir Dar University, College of Medicine and Health Sciences, Department of Biochemistry, Bahir Dar, Ethiopia.

Corresponding author*

Telephone: +251918704688

Email: yohabt22@gmail.com)

Bahir Dar University

Background: Increasing evidence suggests that Methicillin resistant Staphylococcus aureus (MRSA) infections are becoming more prevalent throughout the HIV infected community. Objectives: This study was aimed to determine the prevalence of colonization by MRSA species among HIV positive pediatric patients in the Amhara National Regional State, Northwest Ethiopia. Methods: Participants who attended the clinic from December 2013 through April 2014 were invited to participate in the study. Eligible participants were HIV-infected<18 years of age, receiving medical care at the Paediatric HIV clinics of Felege Hiwot, Dessie, and Debretabor Referral Hospitals. From each participant specimens for S. aurousculture were collected from the anterior nares, the skin of the back of the wrist and the perineum using sterile broth moistened swabs. Swabs were cultured and read according to standard microbiologic procedures. The GenoType MRSA VER 3.0 was used for characterization of S. aurous and S. epidermidis strains among culture positive patients by detecting methicillin resistance-mediating mecA & mecC genes. The bicomponentcytotoxin virulence factor Panton-Valentine leukocidin (PVL) was detected. Data was analyzed by descriptive and logistic regression model using SPSS version 20. The P value of <0.05 was considered as statistically significant.

Results: Among 202 culture positive patients, 126 (62.4%) were also confirmed by GenoType MRSA as S. aurous and of these, 47(37.3%) and 15(11.9%) were mecA and Panton-Valentine leukocidin genes positive respectively.  There was an association between age and S. aurous colonization, (AOR=5.07, 95%CI, 1.10-23.41, P-value=0.03). The study sites, (AOR=4.90, 95%CI, 1.31-18.56, P value=0.01) and PVL gene, (AOR=7.51, 95%CI, 8.82-63.92, P value=0.001) have also significant association with MRSA colonization.

Conclusion and recommendation: High prevalence of pathogenic MRSA strains among HIV positive pediatric patients in the study area. From the PVL gene detection, most of MRSA type was HA MRSA. Hence, strict hygienic approaches by all healthcare workers in hospitals should be implemented to reduce the chance of hospital acquired MRSA infections.

Key words: MRSA, Pediatrics, HIV, Ethiopia