dc.contributor.author | Rutare, Samuel | |
dc.date.accessioned | 2013-11-13T07:20:37Z | |
dc.date.available | 2013-11-13T07:20:37Z | |
dc.date.issued | 2013 | |
dc.identifier.citation | Degree of Masters of Medicine (M.MED) in Paediatrics and Child Health, | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/58806 | |
dc.description | A dissertation in partial fulfillment for the Degree of Masters of Medicine (M.MED)
in Paediatrics and Child Health, University of Nairobi (UON). | en |
dc.description.abstract | Back ground: Methicillin-resistant Staphylococcus aureus (MRSA) remains a public health
problem globally. MRSA infection increases morbidity, risk of mortality, increased financial
burden and loss of productivity. MRSA on average accounts for 57% of S.aureus isolates
causing nosocomial infection in intensive care units (ICUs) and are increasingly reported from
many other countries worldwide. This was the first study to be carried out in Kenyatta National
Hospital (KNH), the national teaching and referral hospital in Kenya to find out the prevalence
of MRSA.
Justification: There has not been any study done to establish the prevalence of MRSA in
Kenyatta National Hospital NICU and ICU. The findings from this study will facilitate rational
planning, protocol and guidelines formulation in both ICU and NICU.
Objective: To determine the prevalence of methicillin resistant Staphylococcus aureus among
paediatric patients admitted in neonatal intensive care unit (NICU) and ICU of KNH.
Methods: This was a cross sectional descriptive study carried out over a period of five months in
NICU and ICU. Children admitted in these units were recruited into the study after getting a
written informed consent from their parents or guardians. Nasal swabs and tracheal aspirates
were collected and taken to Kenya Medical Research Institute (KEMRI)-Microbiology
laboratory where conventional culture techniques, characterization of S. aureus, determination of
the mecA gene for MRSA using PCR techniques and antibiotics susceptibility were performed.
SPSS version 17.0 was used for data analysis.
Results: One hundred and fifty patients were recruited into the study. Of these 99 were males
and 51 females. Sixty seven patients were from NICU and 83 were from ICU. A total of 218
samples (155 nasal swabs and 63 tracheal aspirates) were collected from these patients and
S.aureus was isolated from 71samples (32.6%). Of the 71 S.aureus isolated 33 (46.5%) were
methicillin resistant. S.aureus showed highest sensitivity to vancomycin and linezolid, followed
by amikacin and highly resistance to most of the commonly used antibiotics here at KNH.
Conclusion: Staphylococcus aureus was isolated from one third of the nasal and tracheal
aspirates of patients in the NICU and ICU. MRSA is highly prevalent (46.5%) among the
S.aureus isolates. MRSA isolates were highly sensitive to vancomycin, linezolid and amikacin.
Recommendations: Continuous surveillance of antimicrobial susceptibility to inform policy
and practice, and a study to establish levels of nasal carriage among health workers in these units
should be done. Our second line antibiotics in NICU and ICU are not effective against MRSA
and empiric antibiotic should be vancomycin, amikacin or linezolid. | en |
dc.language.iso | en | en |
dc.publisher | University of Nairobi | en |
dc.title | Prevalence of methicillin resistant staphylococcus aureus (mrsa) among paediatric patients admitted in intensive care unit and neonatal intensive care unit at Kenyatta National Hospital-Nairobi, Kenya. | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | School of Medicine | en |