Antibiotic Resistance Patterns of MRSA associated with Hospital-Acquired Infections in Tertiary Healthcare Facilities in Rwanda

Abstract

Background: Methicillin-Resistant Staphylococcus aureus (MRSA) is a leading cause of Hospital-Acquired Infections (HAIs), contributing to increased morbidity, mortality and healthcare costs. Despite reports of MRSA in Rwanda, its specific role in HAIs within local hospitals remains poorly characterized.

Objectives: In this study, we aimed to investigate antimicrobial resistance patterns of MRSA, characterize mecA gene presence and SCCmec types and identify MRSA associated with nosocomial infections in the Rwandan hospital settings.

Methods: MRSA isolates were obtained from S. aureus-positive clinical samples. Antimicrobial susceptibility testing was performed using a panel of antibiotics. MRSA-associated HAI cases were documented. PCR was used to confirm mecA gene presence and SCCmec typing was conducted to determine genetic diversity.

Results: Results of the 110 S. aureus analyzed, 48% were methicillin-resistant. MRSA cases were distributed across hospital wards: Pediatrics (5), Surgery (3), ICU (3), Neonatology (3), Dialysis (2), PICU (2) and Internal Medicine, HDU, Gynecology and Urology (1 each). MRSA strains exhibited high resistance to penicillin (98%), ampicillin (92%), erythromycin (77%) and ciprofloxacin (73%), while most remained susceptible to linezolid, levofloxacin and vancomycin. Among MRSA-positive cases, 27% were associated with HAIs. Molecular characterization revealed the presence of SCCmec types I, II, IV and V, along with untippable genes, indicating substantial genetic diversity among MRSA strains.

Conclusions: MRSA is prevalent among hospital-acquired infections in Rwanda and is associated with multidrug resistance and diverse genetic profiles. These findings underscore the need to strengthen infection prevention and control strategies to mitigate MRSA-related morbidity and healthcare burden in Rwanda.