Prevalence, Antimicrobial Resistance Patterns, and Risk Factors of Methicillin-resistant Staphylococcus Aureus in Wound Infections at Two Hospitals in Sidama, Ethiopia

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a drug-resistant bacteria that causes serious infections and withstands common antibiotics. It spreads in both hospitals and communities, making it a persistent and dangerous global health threat. Data on its prevalence and drivers in wound infections in Ethiopia, specially in the Sidama region, is limited. This study aimed to determine the prevalence, antimicrobial susceptibility pattern, and risk factors of MRSA isolated from wound infections. Methods: A hospital-based cross-sectional study was conducted at Hawassa Referral and Adare General Hospitals from June to July 2024. A total of 246 participants with wound infections were enrolled using a consecutive sampling technique. Wound swabs were collected and processed for S. aureus following standard microbiological procedures. MRSA was detected using cefoxitin disk diffusion. Data on sociodemographic and clinical variables were collected and analyzed using logistic regression to identify factors associated with MRSA. Results: Out of 246 participants, 76 (30.9%) were positive for S. aureus. The overall prevalence of MRSA was 4.9% (12/246). All MRSA isolates were susceptible to vancomycin and linezolid but showed high resistance to penicillin (100%), clindamycin (66.7%), and erythromycin (50.0%). In the multivariable analysis, male gender (AOR = 1.94, 95% CI: 1.08–3.46), age 31–45 years (AOR = 31.67, 95% CI: 3.26–307.16), rural residence (AOR = 9.11, 95% CI: 1.16–71.70), and deep wound infection (AOR = 28.53, 95% CI: 3.47–234.81) were identified as independent predictors of MRSA. Conclusions: This study reveals a notable prevalence of MRSA in wound infections, with several modifiable risk factors. These findings underscore the urgent need for reinforced infection prevention and control strategies, including targeted antimicrobial stewardship and robust surveillance systems, to curb the spread of MRSA in our healthcare settings.