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