Methicillin-resistant staphylococci among school children in Mariental, Namibia

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to beta-lactam antibiotics, while some strains are multi-drug resistant and may produce disease-causing toxins. Drug resistant strains are often responsible for chronic, persistent and recurrent infections, which pose a challenge for healthcare practitioners. Our study aimed to determine the prevalence of nasal MRSA and methicillin-resistant coagulase-negative staphylococci (MRCoNS) among school children in the Mariental community, southern Namibia. This was a cross-sectional study in the Mariental District. Nasal specimens (swabs) were collected from 272 randomly selected learners aged 6–14 years attending school in the area during the months of March, September and October 2016. Isolation and identification of staphylococci were performed using standard microbiological methods. Methicillin-resistant isolates were identified by their resistance towards cefoxitin (30 μg) using the Kirby-Bauer disk diffusion assay. Enterotoxin production among multi-drug resistant MRSA isolates was detected with a SET-RPLA toxin detection kit. Methicillin-resistant S. aureus was isolated from 48 (17.6%) learners and MRCoNS from only seven (2.6%). Methicillin-resistant S. aureus colonization was significantly higher (P = 0.003) in the age group 11–14 years than in the group 6–10 years. Among the 433 staphylococcal isolates screened for cefoxitin resistance, 51 (11.8%) were MRSA and seven (1.6%) were MRCoNS. From the 51 MRSA isolates, 22 (43.1%) were multi-drug resistant of which six were enterotoxigenic. This is the first report on MRSA and MRCoNS among school children in Namibia. The presence of multidrug resistant and potentially virulent staphylococci among school children in Mariental, Namibia, is of concern. Self-infection by these bacteria poses various health risks for the children. It is recommended that school health programmes improve current hygiene practices. Frequent handwashing can prevent staphylococcal disease and spread of resistant strains among learners and the wider community.