Nasal Colonization among Children with Sickle Cell Disease at the Children's Hospital, Accra: Prevalence, Risk Factors, and Antibiotic Resistance.

The aim of this study was to investigate carriage among children with sickle cell disease (SCD), including the prevalence, risk factors, and antibiotic resistance. The study was cross-sectional, and involved 120 children with SCD recruited at the Princess Marie Louise Children's Hospital (PML) in Accra and 100 apparently healthy children from environs of the hospital. Nasal swab samples were collected from the study participants and cultured for bacteria. Confirmation of and methicillin-resistant (MRSA) isolates were done using the tube coagulase test and A polymerase chain reaction, respectively. All the isolates were tested against standard antimicrobial agents using the Kirby-Bauer method. A structured questionnaire was used to obtain the socio-demographic and clinical data of the study participants. Binary logistic regression was used to identify determinants of and MRSA carriage among the study participants. The nasal carriage prevalence of was 33.3% ( = 40) and 10% ( = 10) among the participants of the SCD and control groups, respectively. As regards MRSA nasal carriage prevalence, the respective values were 3.33% ( = 4) and 0.00% ( = 0). SCD was significantly associated with colonization ( < 0.0001, OR = 4.045), but not MRSA colonization ( = 0.128). In the SCD group, the significant predictors of carriage were increasing age ( = 0.003; OR = 1.275) and living in self-contained apartments ( = 0.033; OR = 3.632), whereas male gender ( = 0.018; OR = 0.344) and the practice of self-medication ( = 0.039; OR = 0.233) were protective of carriage. In the control group, a history of hospitalization in the past year was a risk factor for the carriage of ( = 0.048; OR = 14.333). Among the participants of the SCD and control groups, respectively, the resistance prevalence recorded by against the various antibiotics investigated were penicillin (100% each), cotrimoxazole (27.5% vs. 20%), tetracycline (25% vs. 50%), rifampicin (82.5% vs. 50%), erythromycin (30% vs. 20%), clindamycin (32.5% vs. 50%), gentamicin (7.5% vs. 20%), cefoxitin (27.5% vs. 20%), linezolid (30% vs. 40%), and fusidic acid (95% vs. 80%). The proportion of isolates that were multidrug resistant (MDR) was 92.5% (37/40) in the SCD group and 100% (10/10) in the control group.