Mode
Text Size
Log in / Sign up

MRSA carriage prevalence in Ethiopia is 7.3% with high tetracycline resistance at 55.75%New data reveals risk factors for MRSA carriage in Ethiopia

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Note the 7.3% MRSA carriage prevalence in Ethiopia and the high 55.75% tetracycline resistance rate.

This systematic review and meta-analysis evaluated the prevalence and risk factors of Methicillin-resistant Staphylococcus aureus (MRSA) carriage among a population of 6,869 individuals in Ethiopia. The study aimed to quantify the burden of MRSA in the region and identify specific clinical and environmental factors associated with carriage. The primary focus was on nasopharyngeal carriage as a marker for community and clinical presence.

The analysis synthesized data regarding MRSA carriage prevalence and associated resistance patterns. The primary outcome, pooled carriage prevalence of MRSA, was determined to be 7.3% (95% CI, 5.0-10.8). This figure provides a baseline for the prevalence of MRSA in the studied Ethiopian population. Secondary outcomes included the analysis of resistance patterns to specific antibiotics and the identification of risk factors for MRSA carriage.

Regarding antimicrobial resistance, the meta-analysis reported a resistance rate of 55.75% for tetracycline. Resistance to clindamycin was reported at 12.66%. These figures highlight significant disparities in resistance levels between different classes of antibiotics. The data suggest that while clindamycin resistance is present, tetracycline resistance is notably more prevalent among the carriage population.

Several risk factors were identified as being associated with MRSA carriage. The odds of carriage were significantly increased for individuals with a history of prior hospitalization, with an odds ratio of 3.49. Additionally, the odds of carriage were increased for individuals with a history of antibiotic use, with an odds ratio of 2.35. These findings indicate that both healthcare exposure and prior pharmacological intervention are associated with increased likelihood of MRSA carriage.

Safety and tolerability data were not reported in the primary source, as the study design was a meta-analysis of cross-sectional data rather than a clinical trial. The study did note that the pooled prevalence should be interpreted with caution due to evidence of publication bias. Furthermore, the study noted that the results are associations rather than causal links, as the underlying studies were cross-sectional in nature.

Methodological limitations included inconsistent variable coding across the included studies, which limited the inclusion of other potential risk factors. The presence of publication bias also impacts the certainty of the pooled prevalence figures. These limitations suggest that while the data provide a clear picture of current trends, the full scope of risk factors may not be fully captured.

Clinically, these results highlight the necessity for strengthened antimicrobial stewardship and improved surveillance programs in Ethiopia. The high rate of tetracycline resistance and the association between hospitalization and carriage suggest that targeted prevention efforts are needed for high-risk populations. These findings provide a baseline for local health authorities to develop targeted interventions for MRSA management.

Questions remain regarding the specific strains of MRSA circulating in the region and the impact of these carriage rates on clinical outcomes. Further research is needed to determine if the identified risk factors, such as prior antibiotic use, lead to specific clinical complications or if they primarily reflect the role of healthcare settings as vectors for transmission.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in regional surveillance for MRSA in Ethiopia. It complements the finding that Salmonella prevalence in Ethiopia is 6.7%, providing a broader picture of the local microbial landscape. Additionally, the high tetracycline resistance (55.75%) noted here contrasts with the high tetracycline and cotrimoxazole resistance observed in other African populations, reinforcing the need for targeted stewardship.

MRSA is a type of bacteria that can cause serious infections. It is particularly concerning because it is resistant to some common antibiotics, making it harder for doctors to treat. For many people, the biggest worry is how this bacteria spreads in communities and hospitals. Understanding who is most likely to carry MRSA in their nose or throat is a vital step in preventing the spread of infection and keeping patients safe.

To get a clearer picture of the situation, researchers conducted a meta-analysis. This is a type of study that combines the results of many different studies to find a broader trend. They looked at data from 6,869 people in Ethiopia who were tested for MRSA carriage in their nasopharyngeal area, which is the upper part of the throat and nose. By combining these results, they were able to look at the big picture of how common the bacteria is and what factors might lead to someone carrying it.

The study found that about 7.3% of the people tested carried MRSA. While this might seem like a small number, the researchers looked closer at what made that number go up. They found that people who had been hospitalized in the past were much more likely to carry the bacteria. Additionally, people who had used antibiotics previously also showed a higher risk of carrying MRSA. The study also looked at how the bacteria reacted to specific medications. They found that over half of the cases showed resistance to tetracycline, while about 12.66% showed resistance to clindamycin.

It is important to keep these findings in perspective. Because this was a meta-analysis of cross-sectional studies, the results show associations, not direct causes. For example, while hospital stays are linked to carrying MRSA, the study does not prove that the hospital visit was the only reason. There is also a possibility of publication bias, which means the results should be viewed with some caution.

For patients and healthcare providers, these findings highlight how important it is to manage antibiotic use carefully. Since both past hospitalizations and prior antibiotic use are linked to higher rates of MRSA, these groups may need extra attention. For now, these results do not change immediate medical treatments, but they do help experts create better plans for monitoring and preventing the spread of MRSA in high-risk groups.

What this means for you:
Past hospital stays and antibiotic use are linked to a higher risk of carrying MRSA in the nose and throat.

Study Details

Study typeMeta analysis
Sample sizen = 6,869
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
Methicillin-resistant Staphylococcus aureus (MRSA) nasopharyngeal carriage is a major global health concern linked to severe infections and transmission. However, comprehensive evidence on the burden of MRSA carriage, antimicrobial resistance, and associated risk factors in Ethiopia remains limited. This study aimed to estimate pooled prevalence, resistance pattern, and determinants of nasopharyngeal MRSA carriage. PubMed, ScienceDirect, Scopus, Web of Science, Google Scholar, and gray literature were searched for cross-sectional studies published between January 2015 and December 2025. Two groups of reviewers screened studies based on predefined criteria. The risk of bias was assessed using the Joanna Briggs Institute tool. Pooled prevalence and resistance proportions were estimated using a random-effects model, and pooled odds ratios (ORs) were calculated using the Mantel-Haenszel method. Heterogeneity and publication bias were assessed, and a sensitivity analysis was conducted. A total of 1040 records were identified, and 20 studies (6869 participants) were included. The pooled carriage prevalence was 7.3% (95% CI, 5.0-10.8), with substantial heterogeneity (I = 95.5%). Resistance was highest to tetracycline (55.75%) and lowest to clindamycin (12.66%). Increased odds of carriage were associated with prior hospitalization (OR, 3.49) and antibiotic use (OR, 2.35). Inconsistent variable coding across included studies limited the inclusion of other potential risk factors. Evidence of publication bias was detected, suggesting that the pooled prevalence should be interpreted with appropriate caution. The findings indicate a considerable burden of MRSA and highlight the need for strengthened antimicrobial stewardship, improved surveillance, and targeted prevention efforts in higher-risk populations. This review was registered in PROSPERO (CRD420251047192).
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.