Trends and patterns of antimicrobial resistance among Staphylococcus aureus isolated from various clinical specimens: a national laboratory-based AMR surveillance, 2020–2024

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Methicillin-resistant Staphylococcus aureus (MRSA) is a global public health concern responsible for a wide range of infections. In Ethiopia, patterns and trends of MRSA in various clinical specimens are limited. Therefore, this study aimed to determine the trend and pattern of S. aureus isolated from 16 AMR surveillance sentinel sites. Laboratory-based AMR surveillance data from 2020 to 2024 was collected from various clinical specimens. Culture and antimicrobial susceptibility testing were performed using standard microbiology techniques. The data were analyzed using WHONET 2025 software version 25.15.5 and SPSS version 22. A total of 4,243 S. aureus isolates were analyzed in 16 AMR sentinel sites; most of them were from health facilities in Addis Ababa (46.6%). The trend of penicillin resistance among tested isolates showed persistently high (~ 90%) between 2020 and 2024. The trend of MRSA showed a noticeable slight decline from 37% in 2021 and 2022 to 30% in the 2024 period, and its overall prevalence was 32.2% (95% CI 30.3, 34.2). There has been a slight declining trend of MRSA since 2022 and fluctuating resistance rates in routinely tested antimicrobials. The susceptibility of isolates to last-resort antibiotics remains promising for treatment. The significant presence of MRSA in participating hospitals warrants continuous surveillance and strengthens the implementation of infection prevention and control measures.

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