Prevalence of methicillin-resistant Staphylococcus aureus on water closet seats in public washrooms in the Tamale Metropolis and Tolon District, Ghana

The role of public washrooms in the eradication of open defecation in low and middle income countries is well acknowledged. Notwithstanding, the use of public washrooms come with its own challenges, thus providing an ideal setting for the growth and spread of diverse pathogens including Methicillin Resistant Staphylococcus aureus (MRSA). This study determined the occurrence of S. aureus on water closet seats in public places as well as their antimicrobial susceptibility. A total of 102 swab samples were collected from water closet seats of public toilets in five distinct locations in the Tamale metropolis and Tolon district of Northern Ghana. S. aureus were isolated on prepared Baird Parker agar and confirmed following standard microbiological procedures. Susceptibility to cefoxitin and other commonly prescribed antibiotics were obtained by the Kirby-Bauer disk diffusion test. The cefoxitin disk differentiated S. aureus strains into MRSA and Methicillin-susceptible S. aureus (MSSA). Eighty samples representing 78.4% were positive for S. aureus, of which 35 (43.8%) were MRSA. About 71% of the MRSA strains were multidrug resistant. Seven MRSA isolates showed resistance to all tested antibiotics. Erythromycin was the least effective while gentamicin was the most active antibiotic. The results expose the unhygienic conditions of public washrooms which could become a source for acquiring infections particularly of the urinary tract. The facilities could also serve as reservoir for the spread of not only pathogenic microbes but resistance genes, contributing to the antimicrobial resistance menace. The study therefore considers the maintenance of public washrooms in Northern Ghana a public health worry and recommends that efforts are made to regularly clean and disinfect the facilities to make them safe for public use.   Key words: Methicillin-resistant Staphylococcus aureus, washroom, water closet seats, Tamale, Ghana.