ISPUB.COM The Internet Journal of Infectious Diseases Volume 7 Number 2 1 of 6 Prevalence of Methicillin resistant Staphylococcus aureus (MRSA) among isolates from surgical site infections in Mulago hospital- Kampala, Uganda. J Ojulong, T Mwambu, M Jolobo, E Agwu, F Bwanga, C Najjuka, D Kaddu- Mulindwa Citation J Ojulong, T Mwambu, M Jolobo, E Agwu, F Bwanga, C Najjuka, D Kaddu-Mulindwa. Prevalence of Methicillin resistant Staphylococcus aureus (MRSA) among isolates from surgical site infections in Mulago hospital- Kampala, Uganda.. The Internet Journal of Infectious Diseases. 2008 Volume 7 Number 2. Abstract Background. Methicillin-resistant Staphylococcus aureus (MRSA) isolates are resistant to penicillins and all other β-lactam antibiotics. Nosocomial MRSA are also resistant to a variety of other antibiotic classes. MRSA infections are associated with a high morbidity and mortality in Uganda. There is limited data on the magnitude of MRSA in surgical site infections. The objective of this study was to determine the prevalence of MRSA among S. aureus isolates from surgical site infections in Mulago Hospital, Kampala, Uganda. Methods One hundred eighty eight pus swabs were collected from patients with surgical site infections. Swabs were inoculated for culture at the Microbiology laboratory Faculty of Medicine, Makerere University. S. aurues was identified biochemically. All S. aureus isolates were subjected to oxacillin agar screen and then tested with a polymerase chain reaction (PCR) assay for detection of the mec A gene which codes for oxacillin resistance. Results Out of the 188 specimen cultured, 54 (28.7%) grew S. aureus. Seventeen (31.5%) of the 54 isolates were confirmed as MRSA by PCR. Conclusion. S. aureus is highly (28.7%) prevalent in surgical site infections in Mulago National Referral Hospital, Kampala Uganda. MRSA is highly (31.5%) prevalent among populations of S. aureus isolated from surgical site infections in Mulago National Referral Hospital, Kampala Uganda INTRODUCTION Staphylococcus aureus continues to be a major cause of both nosocomial and community-acquired infections. Methicillin was first introduced in 1960 for the treatment of penicillinase-resistant microbial infections and a year later, MRSA isolates resistant to all β- lactam antibiotics were isolated (Chambers, 2001). Oxacillin resistance (presence of the mecA gene responsible for oxacillin resistance) is a specific predictor of resistance to all β- lactam antibiotics including carbapenems (Chambers, 2001). Methicillin- resistant Staphylococcus aureus (MRSA) has become one of the most important pathogens that cause postoperative infections and it accounts for up to 40% of nosocomial Staphylococcus aureus infections in large Hospitals and 25%-30% in smaller hospitals in the USA (Murray et al, 2003, Ajali, 1999 & Rodriguez et al 1974). In Europe, MRSA prevalence ranges from over 50% in Portugal and Italy to below 2% in Switzerland and the Netherlands, where infection control measures have been shown to work (Verhoef et al, 1999). In Asia, the prevalence lies around 50%, with extremely high rates in Hong Kong (75%) and Japan (72%) (Diekema et al, 2000). In other studies comprising of many African Hospitals the prevalence of MRSA was put at 15 % with Kenya and Nigeria having the highest prevalence of 21-30 % (Gorwitz et al,2006 ). In Uganda, about 10% of the surgical procedures become septic which account for an increasing morbidity and mortality with the commonest organism isolated being S. aureus, though no MRSA had been isolated by 1999.(Ojikan- Odeke.,1978, Mugisa D.B,1998 & Olaro .C, 1999) MRSA infections are of special concern because these infections are associated with prolonged hospital stay, increased hospital costs, and have a few therapeutic options for affected patients (Saxen et al 2003). There is limited