Antibiotic Resistance and Associated Factors with Purulent Skin Infections Due to Staphylococcus Aureus

Author(s): Lalaina Mamenosoa Rakotondraoelina, Zafindrasoa Domoina Rakotovao-Ravahatra, Solofo Sarah Rafaramalala, Andriamiadana Luc Rakotovao, Andry Rasamindrakotroka

Background: Purulent skin infections due to Staphylococcus aureus are common in hospitals and are frequently due to secondary bacterial infections. The aims of this study were to evaluate antibiotic resistance and to describe the factors associated with Staphylococcus aureus purulent skin infections.

Methods: This is a descriptive and cross-sectional study of 179 results of cytobacteriological examinations of pus over a period of 18 months, from January 2021 to June 2022, at the laboratory of the University Hospital of Befelatanana.

Results: Among the 179 cytobacteriological examinations of pus, 131 cases were positive showing a hospital prevalence of 73.2%. Among the germs identified, 46 cases (25.7%) were represented by isolates of Staphylococcus aureus. Regarding the associated factors, subjects aged 60 and over (30%) (p=0.32; NS), women (32.8%) (p=0.11; NS) and patients hospitalized in Internal Medicine departments (39.3%)(p=0 .02) were the most affected by Staphylococcus aureus purulent skin infections. Concerning the results of the antibiograms, the resistances of the isolates of Staphylococcus aureus to Penicillin G (97.8%), to Doxycycline (56.5%) and to Cotrimoxazole (41.3%) were the highest. Methicillin-resistant Staphylococcus aureus isolates were rare (4.3%) and all isolates were susceptible to Vancomycin.

Conclusion: The prevention of cutaneous suppuration in vulnerable people is very important in hospital departments as well as hospital hygiene measures to fight against nosocomial infections. Similarly, it is necessary to limit the use of broad-spectrum antibiotics in hospital departments to control the evolution of Staphylococus aureus isolates towards increasing antibiotic resistance.