Nasal carriage rate, associated factors, and antimicrobial susceptibility patterns of methicillin resistance among pre-clinical undergraduate students at the College of Health and Medical Sciences, Haramaya University, Ethiopia.

Background: nasal carriage has been linked to higher rates of infection and morbidity. People with Methicillin-resistant can be a potential source of infection for others. University students living together in crowded conditions increase their risk of acquiring infections. The prevalence of , particularly Methicillin-resistant nasal carriage, in Ethiopian university students is sparse.

Objective: This study aimed to determine the nasal carriage rate, associated factors, and antimicrobial susceptibility patterns of methicillin-resistant among pre-clinical students at the College of Health and Medical Sciences, Haramaya University, Ethiopia, from 1 July to 30 August 2022.

Methods: An institutional-based cross-sectional study was conducted among 270 randomly selected pre-clinical Health and Medical Sciences students. Data on associated factors were collected using pre-tested, structured questionnaires. A nasal swab was taken from each participant and sent to the microbiology laboratory via Amies transport media in a cold chain. There, it was cultivated using conventional techniques. The isolated colonies were found to be , and its antimicrobial susceptibility was performed using the Kirby-Bauer disk diffusion method on Muller-Hinton agar. Methicillin-resistant expressing using cefoxitin based on CLSI breakpoint. Data were entered into Epi-Data version 4.4.2.1 and exported to the Statistical Package for Social Sciences (SPSS) software version 25 for analysis. Pearson's chi-square test was performed to predict the associations between variables. A -value less than 0.05 was regarded as statistically significant.

Result: Methicillin-resistant nasal carriage was 5.9% (95% CI: 3.09-8.7) of cases of nasal colonization, which was found to be 12.96% (95% CI: 8.85-16.96). Methicillin-resistant nasal colonization was significantly associated with the history of cigarette smoking ( = 0.000), intake of khat ( = 0.042), nose-picking habit ( = 0.003), history of sharing personal goods ( = 0.021), and history of hospitalizations ( = 0.00). All of the Methicillin-resistant isolates were resistant to ampicillin and cefoxitin.

Conclusion: Based on the findings, a considerable proportion of healthy students harbored Methicillin-resistant strains associated with behavioral factors. Furthermore, these isolates showed high resistance to cefoxitin and ampicillin. Hence, it is crucial to regularly test pre-clinical students to prevent endogenous infections and the spread of Methicillin-resistant .