Incidence Of Methicillin Resistant Staphylococcus Aureus Isolated From Nostrils Of School Pupils In Ikwuano

ABSTRACT

This study was carried out to determine the incidence of Methicillin Resistant Staphylococcus aureus (MRSA) nasal carriage among school pupils of Ikwuano . A total of 100 randomly selected pupils of Divine Vessel of Mercy Academy Nursery/Primary School Oboro Umuariaga and Amawom Community Nursery/Primary School Oboro Amawom both in Ikwuano Local Government of Abia state younger than 12 years were included in the study. Nasal swabs specimens collected were cultured on Mannitol salt agar.  S. aureus isolates were identified by mannitol fermentation, coagulase positivity and catalase positivity. Antimicrobial susceptibility test was performed on Meuller-Hinton Agar (MHA) by modified Kirby-Bauer disc diffusion method. Out of the 100 nasal swabs collected, S. aureus was isolated in 60 (60%). Among the isolates, 63.3% (n=38) were from male children whereas 36.7% (n=22) were from female. There was no significant sex difference in colonization of S. aureus between male and female pupils. Out of 60 isolates, 60% (n=39) were MRSA. MRSA isolates showed high rate of resistance towards antibiotics Imipenem (100%) followed by Cefotaxime (90%), Cefoxitin (65%), Azithromycin (55%), Cefuroxime (50%), Ceftriaxone (41.67%), Gentamycin (18.33%), Ciprofloxacin (18.33%),  and Lefofloxacin (18.33%).This study showed a high incidence of MRSA carriage in school pupils of Ikwuano indicating the spread of MRSA in the community.

TABLE OF CONTENTS

Title Page ﾿   ﾿ i

Certification ﾿ ii

Dedication ﾿ iii

Acknowledgements ﾿ iv

Table of Contents ﾿ v

List of Tables ﾿ vii

Abstract ﾿ viii

CHAPTER ONE: INTRODUCTION ﾿ 1

1.1 ﾿ Virulence Factors of S. aureus ﾿ 3 ﾿

1.2 ﾿ MRSA ﾿ 3

1.3 ﾿ Vancomycin Resistant S. aureus ﾿ 6

1.4 ﾿ Modes of Transmission ﾿ 7

1.5 ﾿ MRSA Colonization ﾿ 8

1.6 ﾿ MRSA Infection ﾿ 8

1.6.1 ﾿ Bacteremia ﾿ 9

1.6.2 ﾿ Endocarditis ﾿ 9

1.6.3 ﾿ Metastatic Infections ﾿ 9

1.6.4 ﾿ Sepsis ﾿ 10

1.6.5 ﾿ Toxic Shock Syndrome ﾿ 10

1.7 ﾿ Aims and Objective ﾿ 10 ﾿

CHAPTER TWO: LITERATURE REVIEW                                                                   11

2.1 ﾿ Epidemiology of MRSA ﾿ 12

2.2 ﾿ Prevalence of MRSA amongst School Children ﾿ 12

2.3 ﾿ Antimicrobial Evaluation of MRSA Nasal Carriage amongst Healthy Students ﾿ 13

2.4 ﾿ Public Health Burden of MRSA in Africa ﾿               ﾿ 13

CHAPTER THREE: MATERIALS AND METHODS ﾿ 15

3.1 ﾿ Study Area ﾿ 15

3.2 ﾿ Collection of Samples ﾿ 15 ﾿

3.3 ﾿ Preparation of Culture Media ﾿ 15

3.4 ﾿ Inoculation and Isolation ﾿ 15

3.5 ﾿ Purification of Isolates ﾿ 16

3.6 ﾿ Identification of the Isolates ﾿ 16

3.7 ﾿ Gram Staining ﾿ 16

3.8 ﾿ Biochemical Test ﾿ 17

3.8.1 ﾿ Catalase Test ﾿ 17

3.8.2 ﾿ Coagulase Test ﾿ 17

3.9 ﾿ Antibiotic Susceptibility Testing ﾿ 17

CHAPTER FOUR: RESULTS ﾿ 18

CHAPTER FIVE: DISCUSSION AND CONCLUSION ﾿ 22

5.1 ﾿ Discussion ﾿ 22

5.2 ﾿ Conclusion ﾿ 23

﾿ References ﾿ 24