Methicillin and Vancomycin Resistant Staphylococcus aureus and Associated Factors from Surgical Ward Inpatients at Debre Markos Referral Hospital, Northwest Ethiopia

Figures & data

Table 1 Sociodemographic and Clinical Characteristics of Participants, DMRH, February to April 2020

Variables	Characteristics	Frequency (N)	Percentage (%)
Gender	Male	172	71.1
	Female	70	28.9
Age (years)	<15 years	34	14.0
	15–30 years	93	38.4
	31–45 years	64	26.4
	46–60 years	33	13.6
	>60 years	18	7.4
HIV	Yes	127	52.5
	No	115	47.5
Residence	Rural	171	70.7
	Urban	71	29.3
Type of wound	Surgical wound	46	19.0
	Nonhealing ulcer	19	7.9
	Burn wound	16	6.6
	Trauma	139	57.4
	Abscess	16	6.6
	Others	6	2.5
Hospital stay over 72 hrs	Yes	197	77.3
	No	55	22.7
Total		242	100

Abbreviation: DMRH, Debre Markos Referral Hospital.

Table 2 Antibiotic Resistance Pattern of S. aureus Isolates Among Surgical Inpatients at DMRH February to April 2020 (participants=242, S. aureus=71)

Antibiotics	Methods		N (%), %=N/242	N (%), %=N/71	AST result	Strain
Cefoxitin	I–Z	≥22 mm	39 (16.1)	39 (54.9)	S	MSSA
		≤21 mm	32 (13.2)	32 (45.1)	R	MRSA
Vancomycin	MIC	≤2 µg/mL	11 (4.5)	11 (15.5)	S	VSSA
		4–8 µg/mL	11 (4.5)	11 (15.5)	I	VISA
		≥16 µg/mL	10 (4.1)	10 (14.1)	R	VRSA

Abbreviations: S, susceptible; R, resistant; I, intermediate; I-Z, inhibition zone; MIC, minimum inhibition concentration; DMRH, Debre Markos Referral Hospital; MSSA, methicillin sensitive S. aureus; MRSA, methicillin resistant S. aureus; VSSA, vancomycin sensitive S. aureus; VISA, vancomycin Intermediate S. aureus; VRSA, vancomycin resistant S. aureus; AST, antimicrobial susceptibility test.

Figure 1 Proportion of MRSA and VRSA among surgical inpatients disaggregated by demographic and wound features at DMRH from February to April 2020.

Abbreviations: MRSA, methicillin resistant S. aureus; VRSA, vancomycin resistant S. aureus; WT, wound type; WD, wound depth; NHU, nonhealing ulcer; DMRH, Debre Markos Referral Hospital.

Table 3 Clinical and Sociodemographic Analysis for Identification MRSA Predictors from Surgical Inpatients in DMRH, February to April 2020, (N=71)

Variable	MRSA	MSSA	COR (95%CI) P-value	AOR (95%CI) P-value
Gender
Male	16	32	0.22 (0.08–0.64) 0.005	0.25 (0.06–1.08) 0.064
Female	16	7	1	1
Age (years)
<15	3	5	0.771 (0.16–3.79) 0.749
15–30	14	18	0.825 (0.15–4.5) 0.824
31–45	8	11	0.45 (0.06–3.57) 0.45
46–60	4	3	0.4 (0.04–3.955) 0.433
>60	3	2	1	–
Education
Illiterate	14	12	1.685 (0.54–5.31) 0.373	–
Read and write	9	13	1.167 (0.24–5.698) 0.849
Primary school	4	4	2.722 (0.57–12.91) 0.207
Secondary school	3	7	1.75 (0.25–12.28) 0.573
College/University	2	3	1
Occupation
Civil servant	2	2	1.56 (0.19–13.11) 0.685	–
Farmer	9	14	1.00 (0.09–11.03) 1.00
Merchant	4	4	1.00 (0.104–9.61) 1.00
Student	6	6	0.571 (0.06–5.58) 0.635
Housewife	7	4	6.0 (0.34–107.42) 0.224
Daily labor	1	6	1.00 (0.08–12.56) 1.00
Other	3	3	1
Residency
Rural	20	26	0.83 (0.314–2.215) 0.715	–
Urban	12	13	1
Site of infection
Leg	17	20	0.43 (0.04–5.11) 0.5
Foot	2	1	1.7 (0.37–7.85) 0.496
Hand	3	6	1.06 (0.25–4.60) 0.935
Head and neck	4	5	1.06 (0.25–4.60) 0.935
Back abdomen	4	5	0.43 (0.04–5.11) 0.5
Other	2	2	1	–
Wound depth
Deep	19	12	3.29 (1.23–8.76) 0.017	4.38 (1.05–18.29) 0.043
Superficial	13	27	1	1
Type of wound
Surgical wound	4	4	0.5 (0.06–4.47) 0.535
Nonhealing ulcer	4	2	1 (0.12–8.31) 1.00
Burn wound	3	3	1.39 (0.31–6.30) 0.67
Trauma	18	25	2.5 (0.29–21.40) 0.403
Abscess	2	5	1.2 (–) 0.5	-
Others	1	0	1
Diabetes
Yes	9	3	4.70 (1.15–19.19) 0.031	2.63 (0.44–15.59) 0.287
No	23	36	1	1
HIV
Yes	7	2	6.77 (1.25–36.69) 0.027	3.66 (0.34–39.67) 0.287
No	15	29	2.8 (0.45–17.38) 0.269	1.49 (0.13–16.99) 0.748
Unknown	10	8	1	1
Hospital stay >72 h
Yes	27	17	6.99 (2.22–21.96) 0.001	7.40 (1.50–39.49) 0.014
No	5	22	1	1
Previous history of antibiotic
Yes	16	4	8.75 (2.52–30.39) 0.001	0.69 (0.045–10.66) 0.793
No	16	35	1	1
Previous history of wound infection
Yes	17	5	7.71 (2.40–24.77) 0.001	24.3 (3.77–156.89) 0.001
No	15	34	1	1
Malignant disease
Yes	5	1	7.04 (0.78–63.70) 0.083	1.55 (0.04–63.3) 0.817
No	27	38	1
Traditional medicine
Yes	10	4	3.98 (1.11–14.25) 0.034	0.72 (0.103–4.98) 0.74
No	22	35	1	1
Currently on antibiotics
Yes	25	7	4.62 (1.62–13.21) 0.004	7.9 (1.44–43.39) 0.017
No	17	22	1	1

Abbreviations: DMRH, Debre Markos Referral Hospital; MSSA, methicillin sensitive S. aureus; MRSA, methicillin resistant S. aureus; AOR, adjusted odds ratio; P, level of significance, CI, confidence interval.