Epidemiology of Staphylococcus aureus in a burn unit of a tertiary care center in Ghana.

Autor: Amissah NA; Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.; Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana., van Dam L; Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Ablordey A; Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana., Ampomah OW; The Reconstructive Plastic Surgery and Burn Center, Korle Bu Teaching Hospital, Korle Bu, Ghana., Prah I; Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana., Tetteh CS; Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana., van der Werf TS; Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Friedrich AW; Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Rossen JW; Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., van Dijl JM; Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Stienstra Y; Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2017 Jul 13; Vol. 12 (7), pp. e0181072. Date of Electronic Publication: 2017 Jul 13 (Print Publication: 2017).
DOI: 10.1371/journal.pone.0181072
Abstrakt: Background: In developing countries, hospitalized burn victims are at high risk of nosocomial infections caused by Staphylococcus aureus. Risk factors include poor infection control practices, prolonged hospitalisation and limited capacity for laboratory microbiological analyses. These problems are compounded by widespread use of antibiotics that drives the spread of multi-drug resistant bacteria.
Methods: During the study period (November 2014-June 2015), nasal and invasive S. aureus isolates were collected consecutively from patients and healthcare workers (HCWs) within the burn unit of the Reconstructive Plastic Surgery and Burn Center of Korle Bu Teaching Hospital in Ghana. Antibiotic prescription, antibiotic susceptibility and bacterial typing were used to assess antibiotic pressure, antibiotic resistance, and possible transmission events among patients and HCWs.
Results: Eighty S. aureus isolates were obtained from 37 of the 62 included burn patients and 13 of the 29 HCWs. At admission, 50% of patients carried or were infected with S. aureus including methicillin resistant S. aureus (MRSA). Antibiotic use per 100 days of hospitalization was high (91.2 days), indicating high selective pressure for resistant pathogens. MRSA isolates obtained from 11 patients and one HCW belonged to the same spa-type t928 and multi-locus sequence type 250, implying possible transmission events. A mortality rate of 24% was recorded over the time of admission in the burn unit.
Conclusion: This study revealed a high potential for MRSA outbreaks and emergence of resistant pathogens amongst burn patients due to lack of patient screening and extended empirical use of antibiotics. Our observations underscore the need to implement a system of antibiotic stewardship and infection prevention where microbiological diagnostics results are made available to physicians for timely and appropriate patient treatment.
Databáze: MEDLINE
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