Prevalence of methicillin-resistant in a tertiary hospital in Nepal.

Setting: Patan Hospital, Lalitpur, Nepal.

Objectives: To describe 1) the prevalence of methicillin-resistant (MRSA) and its antibiotic sensitivity pattern; 2) the demographic and clinical characteristics associated with MRSA infections; and 3) the treatment outcomes of in-patients with MRSA infection among patients with infection between January 2018 and December 2020.

Design: This was a cross-sectional study using electronic and paper-based hospital records of patients with infection.

Results: Of the 1,804 patients with infection 1,027 patients (57%, 95% CI 55-59) had MRSA. The MRSA were susceptible to vancomycin (100%), linezolid (96%), doxycycline (96%), chloramphenicol (86%) and cotrimoxazole (70%), and resistant to erythromycin (68%), clindamycin (56%), gentamycin (58%), ciprofloxacin (92%) and ofloxacin (91%). The prevalence of MRSA was higher in 2019, among out-patients, and in respiratory samples, and lower in blood samples. Of the 142 in-patients with MRSA, 93% had a successful clinical outcome (cured/improved).

Conclusion: More than 50% of patients with infection had MRSA that were resistant to commonly available antibiotics. This calls for strengthening surveil-lance and good infection control practices in this hospital.