Methicillin Resistant Staphylococcus Aureus from Methicillin Resistant Staphylococcus Aureus in selected secondary schools in Nairobi County, Kenya

Abstract

Staphylococcus aureus is found on most surfaces especially in public areas like hospitals and schools and on frequently touched areas like toilet and class room door handles. Methicillin resistant S. aureus (MRSA) is a strain of S. aureus which is resistant to methicillin. There are two types of MRSA; Community acquired methicillin resistant S. aureus (CA-MRSA) and hospital acquired methicillin resistant S. aureus (HA-MRSA). MRSA in the community presents a significant reservoir that could enter into healthcare facilities and spread among patients and also is a health risk for immunosuppressed populations in the community. The study aimed at determining the prevalence of MRSA isolated from toilet and classroom door handles as a potential source of infection to the students and the workers in selected schools in Nairobi, Kenya. The study also compared the prevalence of MRSA between day and boarding girls, boys and mixed secondary schools. Twelve secondary schools in Nairobi County were randomly selected and 306 samples from both the toilet and classroom door handles were collected using sterile swabs and transported to the National microbiology reference laboratory (NMRL) at the National Public Health Laboratories (NPHL) for Staphylococcus isolation. Sample collection was done over a duration of one month. Isolation of S. aureus was done by use of selective media Mannitol salt agar, antibiotic susceptibility of MRSA isolates was done by disk diffusion method and Polymerase chain reaction (PCR) was used to detect genes for methicillin resistance MecA and PVL genes. The prevalence of S. aureus was 20% and 19.6% of the S. aureus isolated were MRSA positive by both antimicrobial susceptibility test (AST) and PCR detection. MRSA in this study was only found in girls’ schools and mixed schools and none in the boys’ schools. Twenty percent of S. aureus showed the presence of Pantone Valentine Leukocidin (PVL) virulence genes while 8% showed the presence of both genes. Fifty six percent of isolates which contained mecA gene had also PVL genes. The presence of both genes in this study indicates that surveillance and researches on MRSA that carry both PVL and mecA gene should continue to provide a significant insight into the prevalence and epidemiology of these important resistant pathogens. The findings also emphasise the need to formulate hygiene measure in the schools including hand washing and disinfecting of all services that could act as a source of infections on MRSA. This could prevent possible spread of MRSA and other related pathogens to students and workers in the schools especially the food handlers in the school’s kitchen and the community.