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Laurence Yehouenou C, Bogaerts B, Vanneste K, De Keersmaecker SCJ, Roosens NHC, Kpangon AA, Affolabi D, Simon A, Dossou FM, Dalleur O. Whole-Genome Sequencing-Based Screening of MRSA in Patients and Healthcare Workers in Public Hospitals in Benin. Microorganisms 2023; 11:1954. [PMID: 37630513 PMCID: PMC10459514 DOI: 10.3390/microorganisms11081954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 08/27/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) constitutes a serious public health concern, with a considerable impact on patients' health, and substantial healthcare costs. In this study, patients and healthcare workers (HCWs) from six public hospitals in Benin were screened for MRSA. Strains were identified as MRSA using conventional microbiological methods in Benin, and confirmed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in Belgium. Whole-genome sequencing (WGS) was used on the confirmed MRSA isolates, to characterize their genomic content and study their relatedness. Amongst the 305 isolates (304 wound swabs and 61 nasal swabs) that were collected from patients and HCWs, we detected 32 and 15 cases of MRSA, respectively. From this collection, 27 high-quality WGS datasets were obtained, which carried numerous genes and mutations associated with antimicrobial resistance. The mecA gene was detected in all the sequenced isolates. These isolates were assigned to five sequence types (STs), with ST8 (55.56%, n = 15/27), ST152 (18.52%, n = 5/27), and ST121 (18.52%, n = 5/27) being the most common. These 27 isolates carried multiple virulence genes, including the genes encoding the Panton-Valentine leukocidin toxin (48.15%, n = 13/27), and the tst gene (29.63%, n = 8/27), associated with toxic shock syndrome. This study highlights the need to implement a multimodal strategy for reducing the risk of the cross-transmission of MRSA in hospitals.
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Affiliation(s)
- Carine Laurence Yehouenou
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université Catholique de Louvain UCLouvain, Avenue Mounier 73, 1200 Brussels, Belgium;
- Laboratoire de Référence des Mycobactéries (LRM), Cotonou BP 817, Benin;
- Faculté des Sciences de la Santé (FSS), Université d’Abomey Calavi (UAC), Cotonou 01 BP 188, Benin
| | - Bert Bogaerts
- Transversal Activities in Applied Genomics, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium; (B.B.); (K.V.); (S.C.J.D.K.); (N.H.C.R.)
| | - Kevin Vanneste
- Transversal Activities in Applied Genomics, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium; (B.B.); (K.V.); (S.C.J.D.K.); (N.H.C.R.)
| | - Sigrid C. J. De Keersmaecker
- Transversal Activities in Applied Genomics, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium; (B.B.); (K.V.); (S.C.J.D.K.); (N.H.C.R.)
| | - Nancy H. C. Roosens
- Transversal Activities in Applied Genomics, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium; (B.B.); (K.V.); (S.C.J.D.K.); (N.H.C.R.)
| | - Arsène A. Kpangon
- Ecole Nationale des Techniciens Supérieurs en Santé Publique et Surveillance Épidémiologique, Université de Parakou, Parakou, Benin;
| | - Dissou Affolabi
- Laboratoire de Référence des Mycobactéries (LRM), Cotonou BP 817, Benin;
- Faculté des Sciences de la Santé (FSS), Université d’Abomey Calavi (UAC), Cotonou 01 BP 188, Benin
- Centre National Hospitalier et Universitaire Hubert Koutoukou Maga (CNHU-HKM), Cotonou BP 386, Benin
| | - Anne Simon
- Centres Hospitaliers Jolimont, Prévention et Contrôle des Infections, Groupe Jolimont Asbl, Rue Ferrer 159, 7100 Haine-Saint-Paul, Belgium;
| | - Francis Moise Dossou
- Department of Surgery and Surgical Specialties, Faculty of Health Sciences, Campus Universitaire, Champs de Foire, Cotonou 01 BP 118, Benin;
| | - Olivia Dalleur
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université Catholique de Louvain UCLouvain, Avenue Mounier 73, 1200 Brussels, Belgium;
- Pharmacy, Clinique Universitaire Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium
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Hoffmann K, Riediger M, Tersteegen A, Marquardt P, Kahlfuß S, Kaasch AJ, Hagen RM, Frickmann H, Zautner AE. Molecular epidemiology of enterically colonizing Escherichia coli with resistance against third-generation cephalosporins isolated from stool samples of European soldiers with concomitant diarrhea on deployment in Western African Mali. Front Microbiol 2023; 14:1169829. [PMID: 37213500 PMCID: PMC10198576 DOI: 10.3389/fmicb.2023.1169829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/12/2023] [Indexed: 05/23/2023] Open
Abstract
Extended spectrum beta-lactamases (ESBL) are frequently found in Enterobacterales isolates from Western Africa. However, information on the molecular epidemiology of regional ESBL-positive Enterobacterales strains is scarce. In order to provide epidemiological information, ESBL-positive Escherichia coli isolates from stool samples of European soldiers with diarrhea deployed to a field camp in Mali were subjected to whole-genome sequencing (Illumina MiSeq and Oxford Nanopore MinION) and antimicrobial susceptibility testing. With two exemptions, sequence-based analysis suggested an absence of transmission events between soldiers as indicated by a high genetic diversity of isolates and sequence types, confirming previous rep-PCR results. Third-generation cephalosporin resistance was associated with the presence of blaCTX-M-15 genes with (n = 14) and without (n = 5) co-occurring blaTEM-1b genes. Between 0 and 6 virulence and resistance plasmids per isolate were recorded. The detected resistance plasmids could be categorized into five types, which, in turn, share different sequence-identical segments, representing particular antimicrobial resistance gene-associated mobile genetic elements (MGEs). Phenotypic resistance rates within the 19 assessed isolates that showed distinguishable colony morphologies were 94.7% (18/19) against ampicillin-sulbactam and trimethoprim/sulfamethoxazole, 68.4% (13/19) against moxifloxacin, 31.6% (6/19) against ciprofloxacin, 42.1% (8/19) against gentamicin, 31.6% (6/19) against tobramycin, and 21.1% (4/19) against piperacillin-tazobactam and fosfomycin. Virulence-associated genes mediating infectious gastroenteritis were rarely detected. The gene aggR, which is characteristic for enteroaggregative E. coli, was only detected in one single isolate. In summary, we found a variety of different strains and clonal lineages of ESBL-carrying E. coli. Transmission either between soldiers or from common contaminated sources was demonstrated in two cases and played only a minor role in this military field camp, while there were indications that resistance gene bearing MGEs had been exchanged between antimicrobial resistance gene-(ARG-)carrying plasmids.
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Affiliation(s)
- Katharina Hoffmann
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Matthias Riediger
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Aljoscha Tersteegen
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Pauline Marquardt
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Sascha Kahlfuß
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Institute of Molecular and Clinical Immunology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Health Campus Immunology, Infectiology, and Inflammation (GCI3), Medical Center, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- CHaMP, Center for Health and Medical Prevention, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Achim J. Kaasch
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Ralf Matthias Hagen
- Department of Microbiology and Hospital Hygiene, Bundeswehr Central Hospital Koblenz, Koblenz, Germany
| | - Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Hamburg, Germany
- Institute for Medical Microbiology, Virology and Hospital Hygiene, University Medicine Rostock, Rostock, Germany
| | - Andreas E. Zautner
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- CHaMP, Center for Health and Medical Prevention, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- *Correspondence: Andreas E. Zautner,
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Obanda BA, Cook EAJ, Fèvre EM, Bebora L, Ogara W, Wang SH, Gebreyes W, Ngetich R, Wandede D, Muyodi J, Blane B, Coll F, Harrison EM, Peacock SJ, Gitao GC. Characteristics of Staphylococcus aureus Isolated from Patients in Busia County Referral Hospital, Kenya. Pathogens 2022; 11:1504. [PMID: 36558838 PMCID: PMC9781741 DOI: 10.3390/pathogens11121504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022] Open
Abstract
Staphylococcus aureus is an important pathogen associated with hospital, community, and livestock-acquired infections, with the ability to develop resistance to antibiotics. Nasal carriage by hospital inpatients is a risk for opportunistic infections. Antibiotic susceptibility patterns, virulence genes and genetic population structure of S. aureus nasal isolates, from inpatients at Busia County Referral Hospital (BCRH) were analyzed. A total of 263 inpatients were randomly sampled, from May to July 2015. The majority of inpatients (85.9%) were treated empirically with antimicrobials, including ceftriaxone (65.8%) and metronidazole (49.8%). Thirty S. aureus isolates were cultured from 29 inpatients with a prevalence of 11% (10.3% methicillin-susceptible S. aureus (MSSA), 0.8% methicillin resistant S. aureus (MRSA)). Phenotypic and genotypic resistance was highest to penicillin-G (96.8%), trimethoprim (73.3%), and tetracycline (13.3%) with 20% of isolates classified as multidrug resistant. Virulence genes, Panton-Valentine leukocidin (pvl), toxic shock syndrome toxin-1 (tsst-1), and sasX gene were detected in 16.7%, 23.3% and 3.3% of isolates. Phylogenetic analysis showed 4 predominant clonal complexes CC152, CC8, CC80, and CC508. This study has identified that inpatients of BCRH were carriers of S. aureus harbouring virulence genes and resistance to a range of antibiotics. This may indicate a public health risk to other patients and the community.
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Affiliation(s)
- Benear Apollo Obanda
- Department of Veterinary Pathology, Microbiology and Parasitology, University of Nairobi, Nairobi P.O. Box 29053-00625, Kenya
- Global One Health Initiative, Office of International Affairs, The Ohio State University, Columbus, OH 43210, USA
- Centre for Microbiology Research Nairobi, Kenya Medical Research Institute, Nairobi P.O. Box 54840-00200, Kenya
| | | | - Eric M. Fèvre
- International Livestock Research Institute, Nairobi P.O. Box 30709-00100, Kenya
- Institute of Infection, Veterinary & Ecological Sciences, Leahurst Campus, University of Liverpool, Chester High Road, Neston CH64 7TE, UK
| | - Lilly Bebora
- Department of Veterinary Pathology, Microbiology and Parasitology, University of Nairobi, Nairobi P.O. Box 29053-00625, Kenya
| | - William Ogara
- Department of Public Health, Pharmacology and Toxicology, University of Nairobi, Nairobi P.O. Box 29053-00625, Kenya
| | - Shu-Hua Wang
- Global One Health Initiative, Office of International Affairs, The Ohio State University, Columbus, OH 43210, USA
- Division of Infectious Disease, Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Wondwossen Gebreyes
- Global One Health Initiative, Office of International Affairs, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Ronald Ngetich
- Centre for Microbiology Research Nairobi, Kenya Medical Research Institute, Nairobi P.O. Box 54840-00200, Kenya
| | - Dolphine Wandede
- Centre for Microbiology Research Nairobi, Kenya Medical Research Institute, Nairobi P.O. Box 54840-00200, Kenya
| | - Johnstone Muyodi
- The Centre for Infectious and Parasitic Diseases Control Research, Busia P.O. Box 3-50400, Kenya
| | - Beth Blane
- Department of Medicine, University of Cambridge, Cambridge CB2 2QQ, UK
| | - Francesc Coll
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, University of London, London WC1E 7HT, UK
| | - Ewan M. Harrison
- Department of Medicine, University of Cambridge, Cambridge CB2 2QQ, UK
- Wellcome Sanger Institute, Hinxton CB10 1SA, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Sharon J. Peacock
- Department of Medicine, University of Cambridge, Cambridge CB2 2QQ, UK
| | - George C. Gitao
- Department of Veterinary Pathology, Microbiology and Parasitology, University of Nairobi, Nairobi P.O. Box 29053-00625, Kenya
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Özdemir F. Antimicrobial Resistance, Multilocus Sequence, and spa Typing of Staphylococcus aureus Isolated from Retail Raw Meat Products. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6035987. [PMID: 39281059 PMCID: PMC11401655 DOI: 10.1155/2022/6035987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/02/2022] [Indexed: 09/18/2024]
Abstract
With a high capacity to acquire antimicrobial resistance, Staphylococcus aureus is an important pathogen causing severe infections in animals and humans. A total of 50 Staphylococcus aureus isolates from retail ground beef, chicken meat, and fish were characterized by antimicrobial resistance profiling, staphylococcal protein A gene (spa) typing, and multilocus sequence typing (MLST). The broth microdilution test results showed that all isolates were resistant to penicillin and sulphamethoxazole but had varying resistance rates to tetracycline (24%), erythromycin (4%), gentamicin (2%), ciprofloxacin (2%), trimethoprim (2%), and chloramphenicol (0%). The blaZ and sulI genes were detected in 100% of the isolates followed by grlA (94%), norA (92%), tetK (80%), chlA (60%), tetM (26%), aacA-aphD (2%), ermA (2%), fexA (0%), and dfrA (0%). Moreover, 26% of the isolates were multidrug-resistant, with five or more resistance genes. The spa typing analysis revealed 22 spa types, with t091 (16%), t1677 (8%), and t14538 (8%) being the most common, and one new spa type, t19851, was uncovered. MLST identified seven sequence types (STs), with ST7 (40%), ST15 (20%), and ST199 (13%) being the most common, and two STs (ST7435 and ST7436) were newly identified. In this study, S. aureus isolated from raw meat showed multidrug resistance and different clones associated with human infections. As a result, foods of animal origin may act as potential vehicles for transmission of multidrug-resistant S. aureus isolates, and the dissemination of potentially pathogenic clonal types, posing a health risk to humans.
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Affiliation(s)
- Fatma Özdemir
- Faculty of Arts and Sciences, Department of Biology, Bolu Abant Izzet Baysal University, 14030 Gölköy, Bolu, Turkey
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Rakonjac B, Lepšanović Z, Šuljagić V, Jovčić B, Kojić M, Larsen AR, Đurić M, Ćirković I. Predominance of t355/ST152/SCCmec V clonal type among PVL-positive MRSA isolates in a tertiary care hospital in Belgrade, Serbia. PLoS One 2022; 17:e0273474. [PMID: 36074767 PMCID: PMC9455871 DOI: 10.1371/journal.pone.0273474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/09/2022] [Indexed: 11/19/2022] Open
Abstract
Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) is continually changing. Frequency of genotypes typical for community-associated MRSA (CA-MRSA) is increasing in hospitals, as well as resistance to antimicrobial agents. Moreover, different clones predominate in different geographic regions, and temporal shifts occur in the predominant clonal type. The aim of this study was to estimate the prevalence of MRSA, CA-MRSA and PVL-positive MRSA isolates from patients hospitalised in the Military Medical Academy (MMA) and from outpatients, and to perform genotyping of PVL-positive MRSA isolates. MRSA isolates were obtained by standard microbiological techniques. PVL-positive MRSA were detected by single PCR. Determination of SCCmec types in MRSA isolates was done using multiplex PCR and genotyping of PVL-positive MRSA by PFGE, MLST and spa typing. The prevalence of MRSA among S. aureus isolates from different clinical specimens was 43.4%. In outpatients the prevalence of MRSA was 3.2%. SCCmec types specific for CA-MRSA were found in 26% of MRSA isolates from hospitalised patients. In groups, hospitalised patients and outpatients, the prevalence of PVL-positive MRSA isolates was 4%, and all of them harboured SCCmec type V genetic element. PFGE revealed minor differences between four groups of PVL-positive MRSA isolates, but all of them belonged to ST152, and all except one were of the t355 spa type. High prevalence of MRSA and CA-MRSA in MMA, especially the presence of PVL-positive CA-MRSA, represent a serious health threat for patients. Genotype t355/ST152/SCCmec V is the dominant MRSA clone among PVL-positive CA-MRSA.
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Affiliation(s)
| | - Zorica Lepšanović
- Military Medical Academy, Belgrade, Serbia
- Medical Faculty, University of Defence, Belgrade, Serbia
| | - Vesna Šuljagić
- Military Medical Academy, Belgrade, Serbia
- Medical Faculty, University of Defence, Belgrade, Serbia
| | - Branko Jovčić
- Institute of Molecular Genetics and Genetic Engineering, Univerity of Belgrade, Belgrade, Serbia
| | - Milan Kojić
- Institute of Molecular Genetics and Genetic Engineering, Univerity of Belgrade, Belgrade, Serbia
| | - Anders Rhod Larsen
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
| | | | - Ivana Ćirković
- University of Belgrade-Faculty of Medicine, Institute of Microbiology and Immunology, Belgrade, Serbia
- * E-mail:
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Abdullahi IN, Issaoui R, Usman Y. Prevalence and genetic lineages of Staphylococcus aureus nasal colonization and urinary tract infection among people living with HIV/AIDS in Nigeria: A systematic review. IJID REGIONS 2022; 4:17-24. [PMID: 36093365 PMCID: PMC9453218 DOI: 10.1016/j.ijregi.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/14/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
To provide an empirical insight on Staphylococcus aureus (S. aureus) nasal colonization and urinary tract infection (UTI) among people living with HIV/AIDS (PLWHA) in Nigeria, a quantitative synthesis and systematic review were executed. A comprehensive bibliometric search was conducted for published articles using the keywords 'nasal S. aureus carriage', 'Urinary S. aureus', 'nasal MRSA', 'staphylococci-HIV coinfection', 'urinary MRSA' and 'all states of Nigeria'. Eligible studies and the number of subjects (n) were analysed according to the PRISMA criteria. Out of the 79 examined studies, only 6 (n=1181) and 6 (n= 1350) on nasal and urine samples, respectively, were eligible. The pooled prevalence of nasal carriage and UTI of S. aureus were 29.6% and 6.8%, respectively. However, the pooled nasal MRSA carriage was 13.4%. The pooled prevalence of luk-F/S-PV-carrying S. aureus among nasal samples was 13.0%. Molecular typing from 3 studies showed MRSA-ST8-t064 and MSSA-ST15-t084 as the predominant genetic lineages. The S. aureus isolates from both sample types had the highest (>50%) resistance to penicillin, sulfamethoxazole-trimethoprim, erythromycin, and tetracycline. Multi-drug resistance was not significantly higher among S. aureus isolates from urine than nasal samples (60% versus 40.0% of eligible studies) (p= 0.5271). A moderate and high pooled prevalence of genetically diverse MRSA and luk-F/S-PV-carrying S. aureus were obtained from PLWHA, respectively. These findings emphasize the importance of routine screening for MRSA among PLWHA in Nigeria and other HIV endemic countries.
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Affiliation(s)
- Idris Nasir Abdullahi
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, College of Medical Sciences, Ahmadu Bello University, PMB 05 Zaria, Nigeria
| | - Rabeb Issaoui
- Department of Biology, University of Tunis El-Manar, Tunis, Tunisia
| | - Yahaya Usman
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, College of Medical Sciences, Ahmadu Bello University, PMB 05 Zaria, Nigeria
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Morizane A, Uehara Y, Kitamura S, Komori M, Matsushita M, Takeuchi S, Seo H. Staphylococcus aureus
nasal colonization increases the risk of cedar pollinosis. J Gen Fam Med 2022; 23:172-176. [PMID: 35509329 PMCID: PMC9062552 DOI: 10.1002/jgf2.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 11/09/2022] Open
Abstract
Background One‐third of the people in Japan are colonized with Staphylococcus aureus (S. aureus) and suffer from virulence factor‐mediated subclinical inflammation of the nares. We investigated whether subclinical inflammation contributed to cedar pollinosis affecting 20 million people annually. Methods The study participants were 814 inhabitants of the A or B prefectures. We compared the colonization rate and population structure of S. aureus, in association with the prevalence of cedar pollinosis, between participants in these two areas. Results A prefecture had twice the annual amount of airborne cedar pollen compared with B. The prevalence of cedar pollinosis was significantly higher in A (23.5%) than in B (13.1%) (p = 0.0004). Moreover, the prevalence of cedar pollinosis was higher in female participants (23.3%) than in male participants (14.7%) (p = 0.003). In addition, the prevalence of cedar pollinosis was higher in S. aureus carriers (24.2%) than in S. aureus noncarriers (17.9%) (p = 0.03). The isolation rate of clonal complex (CC) 508 was higher in the A group (21%) than in the B group (7%) (p = 0.015). Conclusion Nasal colonization of S. aureus is a major risk factor for cedar pollinosis. However, the direct mechanism of this risk is currently unknown. The prevalence of cedar pollinosis in the research area was proportional to the amount of cedar pollen. The prevalence of cedar pollinosis was higher in S. aureus carriers (24.2%) than in S. aureus noncarriers (17.9%) (p = 0.03). The prevalence of cedar pollinosis was higher in female participants (23.3%) than in male participants (14.7%) (p = 0.003).
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Affiliation(s)
- Atsushi Morizane
- Department of General Medicine Kochi Medical School Hospital Nankoku Japan
| | - Yoshio Uehara
- Department of General Medicine Kochi Medical School Hospital Nankoku Japan
| | - Satoko Kitamura
- Department of General Medicine Kochi Medical School Hospital Nankoku Japan
| | - Masahiro Komori
- Department of Otolaryngology Kochi Medical School Nankoku Japan
| | | | - Seisho Takeuchi
- Department of General Medicine Kochi Medical School Hospital Nankoku Japan
| | - Hiromi Seo
- Department of General Medicine Kochi Medical School Hospital Nankoku Japan
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8
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Ndahetuye JB, Leijon M, Båge R, Artursson K, Persson Y. Genetic Characterization of Staphylococcus aureus From Subclinical Mastitis Cases in Dairy Cows in Rwanda. Front Vet Sci 2021; 8:751229. [PMID: 34869725 PMCID: PMC8637448 DOI: 10.3389/fvets.2021.751229] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/11/2021] [Indexed: 12/04/2022] Open
Abstract
Whole-genome sequencing was carried out on 30 Staphylococcus (S.) aureus isolates from dairy cows with subclinical mastitis from all five provinces of Rwanda. Twenty-five of the isolates produced enough sequence to be analyzed using core genome multilocus sequence typing (cg-MLST). The isolates group into three main clusters. The largest cluster contain isolates of sequence type (ST) 152 (n = 6) and the closely related ST1633 (n = 2). These sequence types have previously mainly been encountered in humans. The isolates of the second-largest cluster belong to ST5477 (n = 5),so far exclusively isolated from cows in Rwanda. The third cluster consists of isolates of ST97 (n = 4), which is a well-known bovine-adapted sequence type. These three clusters were all widespread over the country. Isolates of the usually human-adapted sequence types 1 (n = 2) and 5 (n= 1) were found and a single isolate of ST2430, previously found among humans in Africa. Finally, four isolates of novel sequence types were found: ST7108 (n = 2), ST7109 (n = 1), and ST7110 (n = 1). The blaZ penicillin resistance gene was found in 84% of the isolates and was in all cases corroborated by phenotypic resistance determination. Five (20%) of the isolates carried a tetracycline resistance gene, tet(K) or tetM, and three of these five also displayed phenotypic resistance while two isolates carried a tetM-gene but were yet tetracycline susceptible. Seven (28%) isolates carried the dfrG gene conferring resistance to trimethoprim. Four of these isolates indeed were resistant to trimethoprim while three isolates were sensitive. The str gene conferring resistance to aminoglycosides was found in three isolates; however, none of these displayed resistance to gentamycin. Our data revealed a high diversity of the sequence types of S. aureus isolates from cows with subclinical mastitis in Rwanda. Two major clusters of ST97 and ST5477 are likely to be bovine adapted and cause mastitis while the third cluster of ST152 usually have been found in humans and may signify a recent transmission of these types from human to cows, for example from hand milking. The high prevalence of this sequence type among dairy cows may pose zoonotic threat. The sequence types were widely distributed without any geographic correlation. Penicillin resistance, the most common type of resistance with a prevalence over 80%, but also tetracycline and trimethoprim resistance were displayed by several isolates.
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Affiliation(s)
- Jean Baptiste Ndahetuye
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Department of Veterinary Medicine, College of Agriculture, Animal Sciences and Veterinary Medicine, University of Rwanda, Kigali, Rwanda
| | | | - Renée Båge
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Karin Artursson
- National Veterinary Institute, Uppsala, Sweden.,Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ylva Persson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,National Veterinary Institute, Uppsala, Sweden
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Senok A, Monecke S, Nassar R, Celiloglu H, Thyagarajan S, Müller E, Ehricht R. Lateral Flow Immunoassay for the Detection of Panton-Valentine Leukocidin in Staphylococcus aureus From Skin and Soft Tissue Infections in the United Arab Emirates. Front Cell Infect Microbiol 2021; 11:754523. [PMID: 34733796 PMCID: PMC8558463 DOI: 10.3389/fcimb.2021.754523] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/13/2021] [Indexed: 01/11/2023] Open
Abstract
Introduction Panton Valentine leukocidin (PVL) is a virulence factor which is associated with methicillin sensitive and resistant Staphylococcus aureus (MSSA/MRSA) causing skin and soft tissue infections (SSTI). This study aimed to evaluate a novel lateral flow immunoassay (LFI) for PVL detection in S. aureus cultures and to describe their genotypic characterization. Methods The study was carried out from January-August 2020 in Dubai, United Arab Emirates. S. aureus isolates associated with SSTI were tested for PVL detection using LFI. DNA microarray-based assays were used for molecular characterization including detection of pvl genes. Results One-hundred thirty-five patients with a clinical diagnosis of SSTIs were recruited. Sixty-six patients received antibiotics, mostly beta lactams (n=36) and topical fusidic acid (n=15). One-hundred twenty-nine isolates (MRSA: n=43; MSSA: n=86) were tested by LFI and DNA microarrays. All 76 (58.9%) isolates which were unambiguously negative for the PVL in LFI were negative for pvl genes using the DNA microarray. All the LFI PVL positive isolates (n=53) had pvl genes detected. This translates into 100% each for sensitivity, specificity, positive and negative predictive values for the LFI. The LFI typically takes about 15 min inclusive of a 10 min incubation period. Predominant S. aureus clonal complexes (CC) were CC30 (n=18), CC22 (n=13), CC5 (n=12), CC1 (n=11), CC152 (n=8), CC15 (n=7); CC97 (n=7); CC8 and CC20 (n=6 each). Among MRSA, the proportion of pvl-positives (35/43; 81%) was higher than among MSSA (n/N=18/86; 21%). The fusidic acid resistance gene fusC was detected in 14 MRSA (33%) compared to 8 MSSA (9%). A co-carriage of fusC and pvl genes was present in 7 MRSA and in one MSSA. Conclusion LFI shows excellent diagnostic accuracy indices for rapid identification of PVL in MSSA/MRSA in a setting with high prevalence of pvl+ve strains. The high occurrence of pvl and fusC genes in MRSA strains causing SSTI is of concern and needs constant surveillance.
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Affiliation(s)
- Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Stefan Monecke
- Department of Optical Molecular Diagnostics and System Technology, Leibniz Institute of Photonic Technology (IPHT), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany.,Institute for Medical Microbiology and Virology, Dresden University Hospital, Dresden, Germany
| | - Rania Nassar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Oral and Biomedical Sciences, School of Dentistry, Cardiff University, Cardiff, United Kingdom
| | - Handan Celiloglu
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Department of Pathology & Laboratory Medicine, Mediclinic City Hospital, Dubai, United Arab Emirates
| | - Sreeraj Thyagarajan
- Department of Pathology & Laboratory Medicine, Mediclinic City Hospital, Dubai, United Arab Emirates
| | - Elke Müller
- Department of Optical Molecular Diagnostics and System Technology, Leibniz Institute of Photonic Technology (IPHT), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - Ralf Ehricht
- Department of Optical Molecular Diagnostics and System Technology, Leibniz Institute of Photonic Technology (IPHT), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany.,Institute of Physical Chemistry, Friedrich-Schiller University, Jena, Germany
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10
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Pichon M, Micaelo M, Rasoanandrasana S, Menn AM. Molecular characterization of Staphylococcus aureus isolates derived from severe pneumonia: a retrospective monocentre study. Infect Dis (Lond) 2021; 53:811-819. [PMID: 34382901 DOI: 10.1080/23744235.2021.1963472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Staphylococcus aureus is endowed with a repertoire of virulence factors potentially implicated in its pathogenicity and ability to cause invasive disease. The main objective of this study was to describe the bacterial genotype, including virulence genes and affiliation to clonal complexes (CCs), encountered in severe pneumonia. METHODS DNA microarray was used to analyse 18 S. aureus isolates from patients hospitalized with severe pneumonia between 2017 and 2019. RESULTS Among 18 S. aureus isolates, 14 were methicillin-susceptible S. aureus (MSSA), and 4 methicillin-resistant S. aureus (MRSA). There were 14 community-acquired, 3 healthcare-associated, and 1 hospital-acquired infections. Different radiological presentations were observed: necrotizing pneumonia (n = 8, 44%), alveolar consolidation (n = 7, 39%), alveolar-interstitial infiltrates (n = 3, 17%). Sixteen patients (89%) required ICU hospitalization, 13 (72%) an invasive mechanical ventilation, and 12 (67%) a vasopressor support. Mortality affected 6 patients (33%). Panton-Valentine leukocidin (PVL), staphylococcal enterotoxins, toxic shock syndrome toxine-1 (TSST-1) encoding genes were documented in nine (50%), 12 (67%), one (6%) of the isolates, respectively. Accessory regulator gene group I was the most reported (n = 9, 50%) and was found in five deaths. The majority of isolates were affiliated to CC152 (n = 6), followed by CC15 (n = 3), CC45 (n = 2), CC30 (n = 2), CC1 (n = 2), CC8 (n = 1), CC9 (n = 1), and CC25 (n = 1). All the CC152 isolates were PVL-positive. CONCLUSION CC152-PVL positive S. aureus strains were the most prevalent in severe pneumonia. Other virulence gene profiles were found coupled to additional clonal lineages. A genotyping strategy contributes to describe the current circulating strains and bacterial genetic backgrounds.
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Affiliation(s)
- Maud Pichon
- Service de Médecine Polyvalente, Centre Hospitalier Victor Dupouy, Argenteuil, France
| | - Maïte Micaelo
- Service de Microbiologie, Centre Hospitalier Victor Dupouy, Argenteuil, France
| | | | - Anne-Marie Menn
- Service de Médecine Polyvalente, Centre Hospitalier Victor Dupouy, Argenteuil, France
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11
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Molecular Characterization of Staphylococcus aureus Isolated from Raw Milk Samples of Dairy Cows in Manhiça District, Southern Mozambique. Microorganisms 2021; 9:microorganisms9081684. [PMID: 34442763 PMCID: PMC8402116 DOI: 10.3390/microorganisms9081684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/23/2021] [Accepted: 08/04/2021] [Indexed: 11/18/2022] Open
Abstract
Staphylococcal infections are among the most common foodborne diseases. We performed the antibiotic susceptibility and molecular characterization of S. aureus from milk samples of dairy cows in Manhiça District. We observed a high frequency of S. aureus (41%, 58/143), in which 71% (41/58) were from commercial farms and 29% (17/58) from smallholder farms. Half of the isolates (50%, 29/58) were resistant to at least one antibiotic, with higher rates of resistance to penicillin (43%, 25/58), followed by tetracycline (16%, 9/58). Multidrug-resistant and methicillin-resistant S. aureus isolates were rare (5%, 3/58 and 3%, 2/58, respectively). The genetic diversity was low, with predominance of human-adapted strains being: ST1/CC1-t5388 (78%) and ST152-t1299 (10%), followed by ST8/CC8-t1476 (5%) and ST5/CC5-t002 (3%) and lastly, ST508/CC45-t331 and ST152-t355, with 2% each. The Panton–Valentine leukocidin (PVL) gene was detected among 14% (8/58) of the isolates, while genes encoding staphylococcal enterotoxins were scarce (3%, 2/58). Our findings revealed a high frequency of S. aureus, with high rates of resistance to the antibiotics commonly used in veterinary and human medicine. Further investigations focusing on the molecular epidemiology of S. aureus from cattle and farmers will provide detailed insights on the genetic relatedness between the strains.
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Ackers-Johnson G, Kibombo D, Kusiima B, Nsubuga ML, Kigozi E, Kajumbula HM, Kateete DP, Walwema R, Ackers HL, Goodhead IB, Birtles RJ, James CE. Antibiotic resistance profiles and population structure of disease-associated Staphylococcus aureus infecting patients in Fort Portal Regional Referral Hospital, Western Uganda. MICROBIOLOGY (READING, ENGLAND) 2021; 167:001000. [PMID: 34032566 PMCID: PMC8290103 DOI: 10.1099/mic.0.001000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/01/2021] [Indexed: 11/23/2022]
Abstract
Tackling antimicrobial resistance (AMR) is particularly challenging in low-resource settings such as Fort Portal Regional Referral Hospital (FPRRH) in Western Uganda. Specific knowledge of local AMR epidemiology is required to inform evidence-based improvement of antibiotic stewardship measures in the hospital. To address this, we combined existing antimicrobial susceptibility testing (AST) from FPRRH, with whole genome sequencing (WGS) of 41 Staphylococcus aureus isolates (2017-2019). AST revealed 73 % (30 of 41) of isolates were resistant to one or more antibiotics and 29 % (12 of 41) were multi-drug resistant (MDR). Resistance phenotypes were largely explained by the presence of antibiotic resistance genes in WGS data. Five isolates were methicillin-resistant S. aureus (MRSA) and MDR. Although all isolates were susceptible to clindamycin, a 24 % carriage of erm genes suggests potential for rapid development of resistance. We inferred a population structure for the S. aureus isolates by comparing their core genomes. Twenty isolates formed a tight cluster corresponding to multilocus sequence typing clonal complex (CC) 152, a CC found to be particularly prevalent in northern Africa. The frequency of genes associated with methicillin, chloramphenicol and ciprofloxacin resistance were significantly lower among CC152 strains than non-CC152 strains; thus, in keeping with previous work, we find that CC152 is almost exclusively methicillin-sensitive S. aureus (MSSA). Also, in agreement with other studies, we observed that the occurrence of Panton-Valentine leukocidin toxin-encoding genes was significantly higher among CC152 strains than non-CC152 strains. However, we also observed that the coagulase gene was over-represented in this CC, further defining the virulence strategy of this important pathogen. By generating detailed information about the epidemiology of circulating S. aureus and their antibiotic susceptibility, our study has provided, for the first time, data on which evidence-based infection and AMR interventions at FPRRH can be based.
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Affiliation(s)
- Gavin Ackers-Johnson
- School of Science, Engineering and Environment, University of Salford, Salford, UK
| | - Daniel Kibombo
- Fort Portal Regional Referral Hospital, Uganda, Uganda
- Infectious Diseases Institute, Kampala, Uganda
| | - Brenda Kusiima
- Fort Portal Regional Referral Hospital, Uganda, Uganda
- Infectious Diseases Institute, Kampala, Uganda
| | - Moses L. Nsubuga
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Edgar Kigozi
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | | | | | | | - Ian B. Goodhead
- School of Science, Engineering and Environment, University of Salford, Salford, UK
| | - Richard J. Birtles
- School of Science, Engineering and Environment, University of Salford, Salford, UK
| | - Chloë E. James
- School of Science, Engineering and Environment, University of Salford, Salford, UK
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13
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Egyir B, Bentum J, Attram N, Fox A, Obeng-Nkrumah N, Appiah-Korang L, Behene E, Kumordjie S, Yeboah C, Agbodzi B, Bentil RE, Tagoe R, Kofi Adu Tabi B, Owusu F, Dayie NTKD, Donkor ES, Nsaful J, Asah-Opoku K, Nyarko E, Asumanu E, Larsen AR, Wolfe DM, Letizia AG. Whole Genome Sequencing and Antimicrobial Resistance of Staphylococcus aureus from Surgical Site Infections in Ghana. Pathogens 2021; 10:pathogens10020196. [PMID: 33673230 PMCID: PMC7918159 DOI: 10.3390/pathogens10020196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/16/2022] Open
Abstract
Staphylococcus aureus (S. aureus) is a common cause of surgical site infections (SSIs) globally. Data on the occurrence of methicillin-susceptible S. aureus (MSSA) as well as methicillin-resistant S. aureus (MRSA) among patients with surgical site infections (SSIs) in sub-Saharan African are scarce. We characterized S. aureus from SSIs in Ghana using molecular methods and antimicrobial susceptibility testing (AST). Wound swabs or aspirate samples were collected from subjects with SSIs. S. aureus was identified by matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF-MS); AST was performed by Kirby-Bauer disk diffusion, and results were interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guideline. Detection of spa, mecA, and pvl genes was performed by polymerase chain reaction (PCR). Whole-genome sequencing (WGS) was done using the Illumina MiSeq platform. Samples were collected from 112 subjects, with 13 S. aureus isolates recovered. Of these, 92% were sensitive to co-trimoxazole, 77% to clindamycin, and 54% to erythromycin. Multi-drug resistance was detected in 5 (38%) isolates. The four mecA gene-positive MRSA isolates detected belonged to ST152 (n = 3) and ST5 (n = 1). In total, 62% of the isolates were positive for the Panton-Valentine leukocidin (pvl) toxin gene. This study reports, for the first time, a pvl-positive ST152-t355 MRSA clone from SSIs in Ghana. The occurrence of multi-drug-resistant S. aureus epidemic clones suggests that continuous surveillance is required to monitor the spread and resistance trends of S. aureus in hospital settings in the country.
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Affiliation(s)
- Beverly Egyir
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
- Correspondence:
| | - Jeannette Bentum
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Naiki Attram
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Anne Fox
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra 00233, Ghana;
| | - Labi Appiah-Korang
- Department of Microbiology, Korle-Bu Teaching Hospital, Accra 00233, Ghana;
| | - Eric Behene
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Selassie Kumordjie
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Clara Yeboah
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Bright Agbodzi
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Ronald Essah Bentil
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Rhodalyn Tagoe
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
| | - Blessing Kofi Adu Tabi
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
| | - Felicia Owusu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana; (N.T.K.D.D.); (E.S.D.)
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana; (N.T.K.D.D.); (E.S.D.)
| | - Josephine Nsaful
- Department of Surgery, Korle-bu Teaching Hospital, Accra 00233, Ghana;
| | - Kwaku Asah-Opoku
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana;
| | - Edward Nyarko
- 37 Military Hospital, Accra 00233, Ghana; (E.N.); (E.A.)
| | - Edward Asumanu
- 37 Military Hospital, Accra 00233, Ghana; (E.N.); (E.A.)
| | - Anders Rhod Larsen
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Reference Laboratory for Antimicrobial Resistance, Artillerivej 5, DK-2300 Copenhagen, Denmark;
| | - David M. Wolfe
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Andrew G. Letizia
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
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Wolters M, Frickmann H, Christner M, Both A, Rohde H, Oppong K, Akenten CW, May J, Dekker D. Molecular Characterization of Staphylococcus aureus Isolated from Chronic Infected Wounds in Rural Ghana. Microorganisms 2020; 8:microorganisms8122052. [PMID: 33371449 PMCID: PMC7767444 DOI: 10.3390/microorganisms8122052] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Globally, Staphylococcus aureus is an important bacterial pathogen causing a wide range of community and hospital acquired infections. In Ghana, resistance of S. aureus to locally available antibiotics is increasing but the molecular basis of resistance and the population structure of S. aureus in particular in chronic wounds are poorly described. However, this information is essential to understand the underlying mechanisms of resistance and spread of resistant clones. We therefore subjected 28 S. aureus isolates from chronic infected wounds in a rural area of Ghana to whole genome sequencing. RESULTS Overall, resistance of S. aureus to locally available antibiotics was high and 29% were Methicillin resistant Staphylococcus aureus (MRSA). The most abundant sequence type was ST88 (29%, 8/28) followed by ST152 (18%, 5/28). All ST88 carried the mecA gene, which was associated with this sequence type only. Chloramphenicol resistance gene fexB was exclusively associated with the methicillin-resistant ST88 strains. Panton-Valentine leukocidin (PVL) carriage was associated with ST121 and ST152. Other detected mechanisms of resistance included dfrG, conferring resistance to trimethoprim. CONCLUSIONS This study provides valuable information for understanding the population structure and resistance mechanisms of S. aureus isolated from chronic wound infections in rural Ghana.
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Affiliation(s)
- Manuel Wolters
- Institute of Medical Microbiology, Virology and Hygiene, Universitiy Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany; (M.W.); (M.C.); (A.B.); (H.R.)
| | - Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, 20359 Hamburg, Germany;
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany
| | - Martin Christner
- Institute of Medical Microbiology, Virology and Hygiene, Universitiy Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany; (M.W.); (M.C.); (A.B.); (H.R.)
| | - Anna Both
- Institute of Medical Microbiology, Virology and Hygiene, Universitiy Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany; (M.W.); (M.C.); (A.B.); (H.R.)
| | - Holger Rohde
- Institute of Medical Microbiology, Virology and Hygiene, Universitiy Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany; (M.W.); (M.C.); (A.B.); (H.R.)
| | - Kwabena Oppong
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana; (K.O.); (C.W.A.)
| | - Charity Wiafe Akenten
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana; (K.O.); (C.W.A.)
| | - Jürgen May
- Tropical Medicine II, Universitiy Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany;
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany;
| | - Denise Dekker
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany;
- German Centre for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems, 38124 Braunschweig, Germany
- Correspondence:
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Shen P, Zhou K, Wang Y, Song J, Liu Y, Zhou Y, Xiao Y. High prevalence of a globally disseminated hypervirulent clone, Staphylococcus aureus CC121, with reduced vancomycin susceptibility in community settings in China. J Antimicrob Chemother 2020; 74:2537-2543. [PMID: 31203362 DOI: 10.1093/jac/dkz232] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/22/2019] [Accepted: 05/03/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Most vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous VISA (hVISA) are derived from hospital-associated MRSA due to treatment failure; however, the prevalence of hVISA/VISA in community settings remains unclear. METHODS Four hundred and seventy-six community-associated isolates were collected between 2010 and 2011 during national surveillance for antimicrobial resistance in 31 county hospitals across China. Drug susceptibility evaluation and mecA detection were performed by using broth microdilution and PCR analysis, respectively. hVISA/VISA were identified by using macro-Etest and a modified population analysis profile (PAP)-AUC method. The genetic features of all hVISA/VISA isolates were genotyped. RESULTS Among 476 isolates, MRSA and MSSA accounted for 19.7% (n = 94) and 80.3% (n = 382), respectively. Two VISA and 36 hVISA isolates were identified by PAP-AUC testing. The VISA isolates and 29 of the hVISA isolates were MRSA. The proportion of hVISA/VISA was significantly higher in MRSA (30.9%) than in MSSA (1.8%). The hVISA/VISA isolates were assigned to 18 STs classified into seven clonal complexes (CCs). CC121 (n = 12) followed by ST239 (n = 11) was the most prevalent hVISA/VISA clone. All ST239-hVISA/VISA were MRSA, while 12 CC121-hVISA isolates included 6 MSSA and 6 MRSA isolates. SCCmec III was predominant among MRSA-hVISA/VISA isolates. agr I and agr IV were detected in ST239 and CC121, respectively. All except two strains were positive for Panton-Valentine leucocidin genes. CONCLUSIONS To the best of our knowledge, this is the first report of CC121 as a prevalent hVISA clone in community settings, highlighting the necessity of surveillance and stricter infection control measures for this globally disseminated lineage.
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Affiliation(s)
- Ping Shen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Medicine School, Zhejiang University, Hangzhou, China
| | - Kai Zhou
- Shenzhen Institute of Respiratory Diseases, the First Affiliated Hospital (Shenzhen People's Hospital), Southern University of Science and Technology, Shenzen, China.,Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yu Wang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Medicine School, Zhejiang University, Hangzhou, China
| | - Jingjie Song
- Shenzhen Institute of Respiratory Diseases, the First Affiliated Hospital (Shenzhen People's Hospital), Southern University of Science and Technology, Shenzen, China.,Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, Shenzhen, China
| | - Yang Liu
- Shenzhen Institute of Respiratory Diseases, the First Affiliated Hospital (Shenzhen People's Hospital), Southern University of Science and Technology, Shenzen, China.,Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, Shenzhen, China
| | - Yanzi Zhou
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Medicine School, Zhejiang University, Hangzhou, China
| | - Yonghong Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Medicine School, Zhejiang University, Hangzhou, China
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16
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Baig S, Rhod Larsen A, Martins Simões P, Laurent F, Johannesen TB, Lilje B, Tristan A, Schaumburg F, Egyir B, Cirkovic I, Nimmo GR, Spiliopoulou I, Blanc DS, Mernelius S, Moen AEF, David MZ, Andersen PS, Stegger M. Evolution and Population Dynamics of Clonal Complex 152 Community-Associated Methicillin-Resistant Staphylococcus aureus. mSphere 2020; 5:e00226-20. [PMID: 32611695 PMCID: PMC7333568 DOI: 10.1128/msphere.00226-20] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/12/2020] [Indexed: 11/20/2022] Open
Abstract
Since the late 1990s, changes in the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) were recognized with the emergence of community-associated MRSA (CA-MRSA). CA-MRSA belonging to clonal complex 152 (CC152), carrying the small staphylococcal cassette chromosome mec (SCCmec) type V and encoding the Panton-Valentine leukocidin (PVL), has been observed in Europe. The aim of this study was to investigate its origin, evolution, and dissemination. Whole-genome sequencing was performed on a global collection of 149 CC152 isolates spanning 20 years (93 methicillin-susceptible S. aureus [MSSA] and 56 MRSA isolates). Core genome phylogeny, Bayesian inference, in silico resistance analyses, and genomic characterization were applied. Phylogenetic analysis revealed two major distinct clades, one dominated by MSSA and the other populated only by MRSA. The MSSA isolates were predominately from sub-Saharan Africa, whereas MRSA was almost exclusively from Europe. The European MRSA isolates all harbored an SCCmec type V (5C2&5) element, whereas other SCCmec elements were sporadically detected in MRSA from the otherwise MSSA-dominated clade, including SCCmec types IV (2B), V (5C2), and XIII (9A). In total, 93% of the studied CC152 isolates were PVL positive. Bayesian coalescent inference suggests an emergence of the European CC152-MRSA in the 1990s, while the CC152 lineage dates back to the 1970s. The CA-MRSA CC152 clone mimics the European CC80 CA-MRSA lineage by its emergence from a PVL-positive MSSA ancestor from North Africa or Europe. The CC152 lineage has acquired SCCmec several times, but acquisition of SCCmec type V (5C2&5) seems associated with expansion of MRSA CC152 in Europe.IMPORTANCE Understanding the evolution of CA-MRSA is important in light of the increasing importance of this reservoir in the dissemination of MRSA. Here, we highlight the story of the CA-MRSA CC152 lineage using whole-genome sequencing on an international collection of CC152. We show that the evolution of this lineage is novel and that antibiotic usage may have the potential to select for the phage-encoded Panton-Valentine leukocidin. The diversity of the strains correlated highly to geography, with higher level of resistance observed among the European MRSA isolates. The mobility of the SCCmec element is mandatory for the emergence of novel MRSA lineages, and we show here distinct acquisitions, one of which is linked to the successful clone found throughout Europe today.
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Affiliation(s)
- Sharmin Baig
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anders Rhod Larsen
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Patrícia Martins Simões
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Laurent
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Thor Bech Johannesen
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Berit Lilje
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anne Tristan
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Frieder Schaumburg
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ivana Cirkovic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Graeme R Nimmo
- Pathology Queensland Central Laboratory, Griffith University School of Medicine, Queensland Health, Brisbane, Queensland, Australia
| | - Iris Spiliopoulou
- National Reference Laboratory for Staphylococci, Department of Microbiology, School of Medicine, University of Patras, Patras, Greece
| | - Dominique S Blanc
- Service of Hospital Preventive Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sara Mernelius
- Laboratory Medicine, Jönköping, Region Jönköping County, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Aina Elisabeth Fossum Moen
- Department of Clinical Molecular Biology (EpiGen), Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
- University of Oslo, Oslo, Norway
| | - Michael Z David
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paal Skytt Andersen
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marc Stegger
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
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17
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Molecular Characterization and Pathogenicity of Staphylococcus aureus Isolated from Benin-City, Nigeria. Microorganisms 2020; 8:microorganisms8060912. [PMID: 32560236 PMCID: PMC7356805 DOI: 10.3390/microorganisms8060912] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/13/2020] [Accepted: 06/14/2020] [Indexed: 11/16/2022] Open
Abstract
While numerous studies examine the epidemiology and molecular characterization of Staphylococcus aureus in most developed countries, the detailed molecular characterization and molecular epidemiology of S. aureus strains and clones in Africa is lacking. We determined the molecular epidemiology and virulence of 81 non-duplicate isolates of S. aureus from Benin-City, Nigeria, collected during January–July 2016, and compared with global strains. Forty-seven isolates (58.0%) were found to be methicillin-sensitive Staphylococcus aureus (MSSA), while 34 (42.0%) were methicillin-resistant Staphylococcus aureus (MRSA). ST152-MSSA (24.7%) and ST7-MRSA-V (19.8%) were the dominant groups identified, which were not genetically related to global predominant strains, but rather exhibited regional dominance. An interesting finding of the study was the presence of highly related strains in the region, which differed primarily in their methicillin resistance gene carriage, staphylococcal cassette chromosome mec (SCCmec), with 99.4–99.7% relatedness between the genomes of the strains within the MRSA–MSSA pairs. This suggests that the strains within a pair are experiencing gain or loss of SCCmec within local conditions, with evolution continuing to diversify the strains to a small degree. This study represents the most comprehensive genetic and virulence study of S. aureus in Nigeria.
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18
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Egyir B, Hadjirin NF, Gupta S, Owusu F, Agbodzi B, Adogla-Bessa T, Addo KK, Stegger M, Larsen AR, Holmes MA. Whole-genome sequence profiling of antibiotic-resistant Staphylococcus aureus isolates from livestock and farm attendants in Ghana. J Glob Antimicrob Resist 2020; 22:527-532. [PMID: 32439567 DOI: 10.1016/j.jgar.2020.03.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/25/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Epidemic methicillin-resistant Staphylococcus aureus (MRSA) clones have been described in Ghana, but so far, no typical livestock-associated MRSA isolates (CC398) have been found. In this study we provide baseline information on antimicrobial resistance, population structure, and virulence gene content of S. aureus isolates from livestock and farm attendants. METHODS Nasal samples were collected from cattle, pigs, goats, sheep, and farm attendants from three farms. Staphylococcus aureus was identified by matrix-assisted laser desorption/ionisation time-of-flight and antimicrobial susceptibility testing was performed using VITEK II (Biomerieux, Marcy l'Etoile, France) and interpreted according to EUCAST guidelines. Whole-genome sequencing was performed using the Illumina, San Diego, CA, USA MiSeq Platform. RESULTS In total, 401 nasal swab samples were obtained from 57 farm attendants, 208 pigs, 30 goats, 26 sheep, and 80 cattle. The S. aureus isolates (n = 25) recovered (farm attendants: n = 10; pigs: n = 8; and goats: n = 7) were frequently resistant to penicillin (68%), tetracycline (44%), and ciprofloxacin (32%); two human isolates were MRSA. Twelve isolates (48%) were multidrug resistant (MDR) (>3 classes). Genome sequencing of the isolates revealed ST152-t355, ST9-t1430, and ST133-t8662 as dominant clones among farm attendants, pigs, and goats, respectively. The two MRSA isolates detected belonged to ST8-t334 and ST152-t355. The scn and sak genes associated with human-adaption were detected in 10 isolates; 9 from humans and 1 from a goat. Typing results provided evidence of a single potential transmission event (t861, PVL-, scn+). CONCLUSION No MRSA was detected among livestock, perhaps because of low intensive farming; however, the relatively high prevalence of MDR isolates may be a result of inappropriate antibiotic usage in Ghanaian livestock production.
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Affiliation(s)
- Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana.
| | - Nazreen F Hadjirin
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Srishti Gupta
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Felicia Owusu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Bright Agbodzi
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Tsatsu Adogla-Bessa
- Livestock and Poultry Research Centre Institute of Agricultural and Consumer Sciences, University of Ghana, Legon, Accra, Ghana
| | - Kennedy Kwasi Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Marc Stegger
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anders Rhod Larsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Mark A Holmes
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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19
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Okorie-Kanu OJ, Anyanwu MU, Ezenduka EV, Mgbeahuruike AC, Thapaliya D, Gerbig G, Ugwuijem EE, Okorie-Kanu CO, Agbowo P, Olorunleke S, Nwanta JA, Chah KF, Smith TC. Molecular epidemiology, genetic diversity and antimicrobial resistance of Staphylococcus aureus isolated from chicken and pig carcasses, and carcass handlers. PLoS One 2020; 15:e0232913. [PMID: 32407414 PMCID: PMC7224487 DOI: 10.1371/journal.pone.0232913] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/23/2020] [Indexed: 12/18/2022] Open
Abstract
The epidemiology of Staphylococcus aureus in food animals, associated products, and their zoonotic potential in Nigeria are poorly understood. This study aimed to provide data on the prevalence, genetic characteristics and antimicrobial resistance of S. aureus isolated from chicken and pig carcasses, and persons in contact with the carcasses at slaughterhouses in Nigeria. Surface swabs were collected randomly from 600 chicken and 600 pig carcasses. Nasal swabs were collected from 45 workers in chicken slaughterhouses and 45 pig slaughterhouse workers. S. aureus isolates were analyzed by spa typing. They were also examined for presence of the Panton-Valentine Leucocidin (PVL) and mecA genes, as well as for antimicrobial resistance phenotype. Overall, 53 S. aureus isolates were recovered (28 from chicken carcasses, 17 from pig carcasses, 5 from chicken carcass handlers and 3 from pig carcass handlers). Among the isolates, 19 (35.8%) were PVL-positive and 12 (22.6%) carried the mecA gene. The 53 isolates belonged to 19 spa types. The Based Upon Repeat Pattern (BURP) algorithm separated the isolates into 2 spa-clonal complexes (spa-CC) and 9 singletons including 2 novel spa types (t18345 and t18346). The clonal complexes (CC) detected were CC1, CC5, CC8, CC15, CC88 and CC152. CC15-related isolates represented by spa type t084 (32.1%) and CC5 represented by spa type t311 (35.3%) predominated among isolates from chicken carcasses/ handlers, and pig carcasses/ handlers, respectively. Multidrug resistance exhibited by all the CC except CC8, was observed among isolates from chicken carcasses (64.3%), pig carcasses (41.2%), handlers of chicken meat (40.0%) and handlers of pork (33.3%). All the CC showed varying degrees of resistance to tetracycline while CC15 and CC5 exhibited the highest resistance to sulphamethoxazole/trimethoprim and erythromycin, respectively. The predominant antimicrobial resistance pattern observed was penicillin-tetracycline-sulphamethoxazole/trimethoprim (PEN-TET-SXT). In conclusion, food animals processed in Enugu State in Southeast Nigeria are potential vehicles for transmission of PVL-positive multiple-drug resistant S. aureus and methicillin-resistant S. aureus from farm to slaughterhouse and potentially to the human population. Public health intervention programs at pre- and post-slaughter stages should be considered in Nigerian slaughterhouses.
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Affiliation(s)
- Onyinye J. Okorie-Kanu
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
- * E-mail:
| | - Madubuike U. Anyanwu
- Microbiology Unit, Department of Veterinary Microbiology and Pathology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Ekene V. Ezenduka
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Anthony C. Mgbeahuruike
- Microbiology Unit, Department of Veterinary Microbiology and Pathology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Dipendra Thapaliya
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, Kent State University, Kent, Ohio, United States of America
| | - Gracen Gerbig
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, Kent State University, Kent, Ohio, United States of America
| | - Ejike E. Ugwuijem
- Department of Microbiology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Christian O. Okorie-Kanu
- Department of Veterinary Pathology, Michael Okpara University of Agriculture, Umudike, Abia State, Nigeria
| | - Philip Agbowo
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Solomon Olorunleke
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - John A. Nwanta
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Kennedy F. Chah
- Microbiology Unit, Department of Veterinary Microbiology and Pathology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Tara C. Smith
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, Kent State University, Kent, Ohio, United States of America
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20
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Verdú-Expósito C, Romanyk J, Cuadros-González J, TesfaMariam A, Copa-Patiño JL, Pérez-Serrano J, Soliveri J. Study of susceptibility to antibiotics and molecular characterization of high virulence Staphylococcus aureus strains isolated from a rural hospital in Ethiopia. PLoS One 2020; 15:e0230031. [PMID: 32163464 PMCID: PMC7067403 DOI: 10.1371/journal.pone.0230031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/19/2020] [Indexed: 11/20/2022] Open
Abstract
We characterised 80 Staphylococcus aureus strains isolated from human patients with SSTIs at a rural hospital in Ethiopia. Susceptibility to antibiotic of all strains was tested. The MLST method was used to type and a phylogenetic analysis was conducted employing the sequences of 7 housekeeping genes. PCR amplification was used to investigate the presence of the following virulence genes in all strains: hla (α-haemolysin), tstH (toxic shock syndrome toxin), luk PV (Panton-Valentine leukocidin), fnbA (fibronectin binding protein A) and mecA (methicillin resistance). Most of the strains were resistant to penicillin and ampicillin, but only 3 strains were resistant to oxacillin, and 1 of them was a true MRSA. The MLST results showed a high diversity of sequence types (ST), 55% of which were new, and ST152 was the most prevalent. A phylogeny study showed that many of the new STs were phylogenetically related to other previously described STs, but bore little relationship to the only ST from Ethiopia described in the database. Virulence gene detection showed a high prevalence of strains encoding the hla, fnbA and pvl genes (98.77%, 96.3% and 72.84%, respectively), a low prevalence of the tst gene (13.58%) and a markedly low prevalence of MRSA (1.25%). S. aureus strains isolated from patients in a rural area in Ethiopia showed low levels of antibiotic resistance, except to penicillin. Moreover, this study reveals new STs in Eastern Africa that are phylogenetically related to other previously described STs, and confirm the high prevalence of the pvl gene and the low prevalence of MRSA on the continent.
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Affiliation(s)
- Cristina Verdú-Expósito
- Department of Biomedicine and Biotechnology, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Juan Romanyk
- Microbiology Service, Hospital Universitario Príncipe de Asturias, Alcalá-Meco, Alcalá de Henares, Madrid, Spain
| | - Juan Cuadros-González
- Microbiology Service, Hospital Universitario Príncipe de Asturias, Alcalá-Meco, Alcalá de Henares, Madrid, Spain
| | - Abraham TesfaMariam
- Department of General Medicine, Gambo General Rural Hospital, West-Arsi, Ethiopia
| | - José Luis Copa-Patiño
- Department of Biomedicine and Biotechnology, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Jorge Pérez-Serrano
- Department of Biomedicine and Biotechnology, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Juan Soliveri
- Department of Biomedicine and Biotechnology, University of Alcalá, Alcalá de Henares, Madrid, Spain
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21
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Antonelli A, Giani T, Coppi M, Di Pilato V, Arena F, Colavecchio OL, Conte V, Santerre Henriksen A, Rossolini GM. Staphylococcus aureus from hospital-acquired pneumonia from an Italian nationwide survey: activity of ceftobiprole and other anti-staphylococcal agents, and molecular epidemiology of methicillin-resistant isolates. J Antimicrob Chemother 2019; 74:3453-3461. [PMID: 31652323 DOI: 10.1093/jac/dkz371] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine the prevalence of Staphylococcus aureus from hospital-acquired pneumonia (HAP) in Italy and the susceptibility to ceftobiprole and comparators of MSSA and MRSA isolates. A secondary objective was to characterize the clonality and acquired resistance and virulence genes of MRSA. METHODS Consecutive non-replicate isolates from HAP were collected from 13 laboratories distributed across Italy, from January to May 2016. Antimicrobial susceptibility testing was performed by broth microdilution, and results were interpreted according to the EUCAST breakpoints. All MRSA isolates were subjected to WGS using an Illumina platform. Clonality and resistance and virulence gene content were investigated with bioinformatics tools. RESULTS Among 333 isolates from HAP, S. aureus was the third most common pathogen (18.6%). The proportion of MRSA was 40.3%. Susceptibility to ceftobiprole was 100% for MSSA and 95.5% for MRSA. Lower susceptibility rates of 78.4% and 94.6% in MSSA and 36.4% and 12.1% in MRSA isolates were observed for erythromycin and levofloxacin, respectively. The MRSA from HAP mostly belonged to clonal complex (CC) 22 (47.0%), CC5 (25.8%) and CC8 (15.2%), with a minority of other lineages (ST1, ST6, ST7, ST30, ST152 and ST398). Acquired resistance and virulence genes in most cases exhibited a clonal distribution. The three ceftobiprole-resistant isolates exhibited an MIC of 4 mg/L and belonged to ST228-MRSA-I of CC5. CONCLUSIONS S. aureus is an important cause of HAP in Italy. Ceftobiprole exhibited good in vitro activity against S. aureus isolated from HAP, including MRSA. A trend to replacement of ST228 with ST22 was noticed compared with previous studies.
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Affiliation(s)
- Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Tommaso Giani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Vincenzo Di Pilato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Fabio Arena
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Viola Conte
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
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22
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Kyany'a C, Nyasinga J, Matano D, Oundo V, Wacira S, Sang W, Musila L. Phenotypic and genotypic characterization of clinical Staphylococcus aureus isolates from Kenya. BMC Microbiol 2019; 19:245. [PMID: 31694531 PMCID: PMC6836327 DOI: 10.1186/s12866-019-1597-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The increase and spread of virulent-outbreak associated, methicillin and vancomycin resistant (MRSA/VRSA) Staphylococcus aureus require a better understanding of the resistance and virulence patterns of circulating and emerging strains globally. This study sought to establish the resistance phenotype, and strains of 32 non-duplicate clinical MRSA and MSSA S. aureus isolates from four Kenyan hospitals, identify their resistance and virulence genes and determine the genetic relationships of MRSA with global strains. METHODS Antimicrobial susceptibility profiles were determined on a Vitek 2, genomic DNA sequenced on an Illumina Miseq and isolates typed in-silico. Resistance and virulence genes were identified using ARIBA and phylogenies generated using RAxML. RESULTS The MRSA isolates were 100% susceptible to vancomycin, teicoplanin, linezolid, and tigecycline. Nine distinct CC, 12 ST and 15 spa types including the novel t17826 and STs (4705, 4707) were identified with CC8 and CC152 predominating. MRSA isolates distributed across 3 CCs; CC5-ST39 (1), CC8 - ST241 (4), a novel CC8-ST4705 (1), ST8 (1) and CC152 (1). There was > 90% phenotype-genotype concordance with key resistance genes identified only among MRSA isolates: gyrA, rpoB, and parC mutations, mecA, ant (4')-lb, aph (3')-IIIa, ermA, sat-4, fusA, mphC and msrA. Kenyan MRSA isolates were genetically diverse and most closely related to Tanzanian and UK isolates. There was a significant correlation between map, hlgA, selk, selq and cap8d virulence genes and severe infections. CONCLUSION The findings showed a heterogeneous S. aureus population with novel strain types. Though limited by the low number of isolates, this study begins to fill gaps and expand our knowledge of S. aureus epidemiology while uncovering interesting patterns of distribution of strain types which should be further explored. Although last-line treatments are still effective, the potential for outbreaks of both virulent and resistant strains remain, requiring sustained surveillance of S. aureus populations.
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Affiliation(s)
- Cecilia Kyany'a
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya.,The United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Village Market, Nairobi, Kenya
| | - Justin Nyasinga
- Technical University of Kenya, P.O. Box 52428-00200, Nairobi, Kenya
| | - Daniel Matano
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya.,The United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Village Market, Nairobi, Kenya
| | - Valerie Oundo
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya.,The United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Village Market, Nairobi, Kenya
| | - Simon Wacira
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya.,The United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Village Market, Nairobi, Kenya
| | - Willie Sang
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya
| | - Lillian Musila
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya. .,The United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Village Market, Nairobi, Kenya.
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23
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Fernández-Barat L, Motos A, Panigada M, Álvarez-Lerma F, Viña L, Lopez-Aladid R, Ceccato A, Bassi GL, Nicolau DP, Lopez Y, Muñoz L, Guerrero L, Soy D, Israel T, Castro P, Torres A. Comparative efficacy of linezolid and vancomycin for endotracheal tube MRSA biofilms from ICU patients. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2019; 23:251. [PMID: 31291978 PMCID: PMC6617612 DOI: 10.1186/s13054-019-2523-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/21/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE To compare the efficacy of systemic treatment with linezolid (LNZ) versus vancomycin (VAN) on methicillin-resistant Staphylococcus aureus (MRSA) burden and eradication in endotracheal tube (ETT) biofilm and ETT cuff from orotracheally intubated patients with MRSA respiratory infection. METHODS Prospective observational clinical study was carried out at four European tertiary hospitals. Plasma and endotracheal aspirate (ETA) levels of LNZ and VAN were determined 72 h after treatment initiation through high-performance liquid chromatography or bioassay. LNZ or VAN concentration in the ETT biofilm and MRSA burden and eradication was determined upon extubation. The minimum inhibitory concentration (MIC) for LNZ and VAN was assessed by E-test strips (Biomerieux®). Scanning electron microscopy images were obtained, and ETT biofilm thickness was compared between groups. RESULTS Twenty-five patients, 15 treated with LNZ and 10 with VAN, were included in the study. LNZ presented a significantly higher concentration (μg/mL) than VAN in ETT biofilm (72.8 [1.3-127.1] vs 0.4 [0.4-1.3], p < 0.001), although both drugs achieved therapeutic plasma levels 72 h after treatment initiation. Systemic treatment with LNZ achieved lower ETT cuff MRSA burdens than systemic treatment with VAN. Indeed, LNZ increased the MRSA eradication rate in ETT cuff compared with VAN (LNZ 75%, VAN 20%, p = 0.031). CONCLUSIONS In ICU patients with MRSA respiratory infection intubated for long periods, systemic treatment with LNZ obtains a greater beneficial effect than VAN in limiting MRSA burden in ETT cuff.
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Affiliation(s)
- Laia Fernández-Barat
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain. .,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain.
| | - Ana Motos
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Mauro Panigada
- Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Francisco Álvarez-Lerma
- Critical Care Department, Hospital del Mar, Critical Illness Research Group (GREPAC), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Lucía Viña
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ruben Lopez-Aladid
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Adrian Ceccato
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Gianluigi Li Bassi
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - David P Nicolau
- Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA
| | - Yuli Lopez
- Microbiology Department, Hospital Clínic, CRESIB ISglobal, Barcelona, Spain
| | - Laura Muñoz
- Microbiology Department, Hospital Clínic, CRESIB ISglobal, Barcelona, Spain
| | - Laura Guerrero
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain
| | - Dolors Soy
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Pharmacy Service, Division of Medicines, Hospital Clínic, Barcelona, Spain
| | - Trinidad Israel
- Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Pedro Castro
- Medical Intensive Care Unit, Hospital Clínic, Barcelona, Spain
| | - Antoni Torres
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain. .,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain.
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Multilocus sequence typing and antibiotic resistant patterns of the meticillin-resistant Staphylococcus aureus isolates from different clinical specimens. ACTA ACUST UNITED AC 2019. [DOI: 10.1097/mrm.0000000000000176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Donkor ES, Jamrozy D, Mills RO, Dankwah T, Amoo PK, Egyir B, Badoe EV, Twasam J, Bentley SD. A genomic infection control study for Staphylococcus aureus in two Ghanaian hospitals. Infect Drug Resist 2018; 11:1757-1765. [PMID: 30349333 PMCID: PMC6188180 DOI: 10.2147/idr.s167639] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Whole genome sequencing analysis (WGSA) provides the best resolution for typing of bacterial isolates and has the potential for identification of transmission pathways. The aim of the study was to apply WGSA to elucidate the possible transmission events involved in two suspected Staphylococcus aureus hospital outbreaks in Ghana and describe genomic features of the S. aureus isolates sampled in the outbreaks. Methods The study was carried out at Korle-Bu Teaching Hospital and Lekma Hospital where the suspected outbreaks occurred in 2012 and 2015, respectively. The S. aureus isolates collected from the two hospitals were from three sources including carriage, invasive disease, and the environment. Whole genome sequencing of the S. aureus isolates was performed and the sequence reads were mapped to the S. aureus reference genome of strain USA300_FPR3757. A maximum-likelihood phylogenetic tree was reconstructed. Multilocus sequence typing together with the analysis of antimicrobial resistance and virulence genes were performed by short read mapping using the SRST2. Results The S. aureus isolates belonged to diverse sequence types (STs) with ST15 and ST152 most common. All isolates carried the blaZ gene, with low prevalence of tetK and dfrG genes also observed. All isolates were mecA negative. The pvl genes were common and observed in distinct lineages that revealed diverse Sa2int phages. At Korle-Bu Teaching Hospital, the genomics data indicated several transmission events of S. aureus ST15 involving contamination of various surfaces in the pediatric emergency ward where the outbreak occurred. Conclusion The pattern of dissemination of the ST15 clone in the emergency ward of Korle-Bu Teaching Hospital highlights a basic problem with disinfection of environmental surfaces at the hospital. Diverse phage population rather than a single highly transmissible phage type likely mediates the high prevalence of pvl genes among the S. aureus isolates.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Dorota Jamrozy
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK,
| | - Richael O Mills
- Central Laboratory, Korle-Bu Teaching Hospital, Accra, Ghana.,Department of Biomedical Sciences, University of Cape Coast, Cape Coast Ghana
| | - Thomas Dankwah
- Central Laboratory, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Philip K Amoo
- Public Health Unit, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Beverly Egyir
- Bacteriology Unit, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ebenezer V Badoe
- Department of Child Health, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | | | - Stephen D Bentley
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK,
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26
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Lakhundi S, Zhang K. Methicillin-Resistant Staphylococcus aureus: Molecular Characterization, Evolution, and Epidemiology. Clin Microbiol Rev 2018; 31:e00020-18. [PMID: 30209034 PMCID: PMC6148192 DOI: 10.1128/cmr.00020-18] [Citation(s) in RCA: 778] [Impact Index Per Article: 129.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Staphylococcus aureus, a major human pathogen, has a collection of virulence factors and the ability to acquire resistance to most antibiotics. This ability is further augmented by constant emergence of new clones, making S. aureus a "superbug." Clinical use of methicillin has led to the appearance of methicillin-resistant S. aureus (MRSA). The past few decades have witnessed the existence of new MRSA clones. Unlike traditional MRSA residing in hospitals, the new clones can invade community settings and infect people without predisposing risk factors. This evolution continues with the buildup of the MRSA reservoir in companion and food animals. This review focuses on imparting a better understanding of MRSA evolution and its molecular characterization and epidemiology. We first describe the origin of MRSA, with emphasis on the diverse nature of staphylococcal cassette chromosome mec (SCCmec). mecA and its new homologues (mecB, mecC, and mecD), SCCmec types (13 SCCmec types have been discovered to date), and their classification criteria are discussed. The review then describes various typing methods applied to study the molecular epidemiology and evolutionary nature of MRSA. Starting with the historical methods and continuing to the advanced whole-genome approaches, typing of collections of MRSA has shed light on the origin, spread, and evolutionary pathways of MRSA clones.
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Affiliation(s)
- Sahreena Lakhundi
- Centre for Antimicrobial Resistance, Alberta Health Services/Calgary Laboratory Services/University of Calgary, Calgary, Alberta, Canada
| | - Kunyan Zhang
- Centre for Antimicrobial Resistance, Alberta Health Services/Calgary Laboratory Services/University of Calgary, Calgary, Alberta, Canada
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- The Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
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27
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Rodrigues S, Conceição T, Silva IS, de Lencastre H, Aires-de-Sousa M. Frequent MRSA nasal colonization among hospitalized children and their parents in Angola and São Tomé and Príncipe. J Hosp Infect 2018; 100:344-349. [PMID: 29807064 DOI: 10.1016/j.jhin.2018.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 05/20/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND The prevalence of nosocomial meticillin-resistant Staphylococcus aureus (MRSA) was previously estimated as 23% in a paediatric hospital in Luanda, Angola and 18% in a general hospital in São Tomé and Príncipe. AIM To evaluate the prevalence of S. aureus/MRSA colonization among hospitalized children and their parents at two hospitals in Angola and São Tomé and Príncipe. METHODS In 2017, 127 hospitalized children and 129 of their parents had nasal swabs for S. aureus/MRSA carriage in the two countries. The isolates were tested for the presence of the mecA and Panton-Valentine leukocidin (PVL) genes, and characterized by pulsed-field gel electrophoresis (PFGE), spa typing, multi-locus sequence typing and SCCmec typing. FINDINGS Twenty of 127 children (15.7%) and 13 of 129 parents (10.1%) were MRSA nasal carriers. Three lineages comprised 88% of the MRSA isolates: (i) PFGE A-ST5-SCCmec IVa (N=15; 45%), associated with spa type t105, recovered in Angola alone; (ii) PFGE N-ST8-IV/V (N=7; 21%), associated with spa types t008/t121, recovered in São Tomé and Príncipe alone; and (iii) PFGE B-ST88-IVa (N=7; 21%), associated with spa types t325/t786, present in both countries. Fifteen child/guardian pairs were colonized with identical MRSA (N=8) or meticillin-susceptible S. aureus (N=7) strains. PVL was detected in 25% of isolates, including two MRSA (ST30-V and ST8-IVa). CONCLUSION Hospitalized children and their parents are important reservoirs of MRSA. Infection control measures should focus on parents in order to minimize the spread of MRSA to the community.
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Affiliation(s)
- S Rodrigues
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - T Conceição
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - I Santos Silva
- Escola Superior de Saúde da Cruz Vermelha Portuguesa, Lisboa, Portugal
| | - H de Lencastre
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal; Laboratory of Microbiology and Infectious Diseases, The Rockefeller University, New York, USA
| | - M Aires-de-Sousa
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal; Escola Superior de Saúde da Cruz Vermelha Portuguesa, Lisboa, Portugal.
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28
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Baig S, Johannesen TB, Overballe-Petersen S, Larsen J, Larsen AR, Stegger M. Novel SCCmec type XIII (9A) identified in an ST152 methicillin-resistant Staphylococcus aureus. INFECTION GENETICS AND EVOLUTION 2018; 61:74-76. [PMID: 29567305 DOI: 10.1016/j.meegid.2018.03.013] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/09/2018] [Accepted: 03/16/2018] [Indexed: 11/17/2022]
Abstract
We identified a novel staphylococcal cassette chromosome mec (SCCmec) element in an ST152 methicillin-resistant Staphylococcus aureus (MRSA) isolate by combining Illumina and MinION sequencing. The element contains a new ccrC allotype designated ccrC2. The mec complex resembles mec class A, but with an altered organization of the genes. The element was acknowledged as novel by the International Working Group on the Classification of Staphylococcal Cassette Chromosome Elements (IWG-SCC) and designated SCCmec type XIII (9A).
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Affiliation(s)
- Sharmin Baig
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Thor Bech Johannesen
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | | | - Jesper Larsen
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anders Rhod Larsen
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Marc Stegger
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark.
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29
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Strommenger B, Layer F, Werner G. Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus in Workers in the Food Industry. STAPHYLOCOCCUS AUREUS 2018. [PMCID: PMC7150186 DOI: 10.1016/b978-0-12-809671-0.00009-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Staphylococcus aureus is part of the common flora on the skin and mucous membranes of mammals and approximately 20–30% of humans are persistently colonized, mainly by mostly susceptible human-adapted isolates. In contrast, colonization with methicillin-resistant S. aureus is rare (approximately 1%), predominantly transient and associated with prior contact to the health care system. Additionally, in recent years livestock-associated S. aureus clones contributed to colonization in humans, especially in those working in close contact to farm animals. A considerable percentage of colonizing S. aureus isolates is equipped with enterotoxin genes. Humans carrying enterotoxigenic isolates represent a contamination source when handling food, thus generating a continuous risk of S. aureus food intoxication. Molecular characterization of isolates colonizing humans and obtained from food, respectively, enables the tracing of food-related outbreaks back to the source of food intoxication. We will summarize current knowledge about the S. aureus population colonizing humans, including those in close contact to animals and food, respectively. Additionally, we will review data on the molecular characterization of S. aureus isolates related to staphylococcal foodborne disease and the elucidation of staphylococcal foodborne outbreaks. Staphylococcal food poisoning is a common foodborne disease, mediated by the ingestion of enterotoxins produced by enterotoxigenic strains of S. aureus. For several outbreaks of foodborne S. aureus disease, colonized personnel could be identified as the source of food contamination. However, because of the widespread occurrence of enterotoxigenic strains as human colonizers and the often transient nature of colonization, the source of contamination cannot always be identified unambiguously. Therefore, compliance with hygiene measures is the most important requirement to prevent food contamination by both human colonization and environmental S. aureus reservoirs.
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30
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Amissah NA, Buultjens AH, Ablordey A, van Dam L, Opoku-Ware A, Baines SL, Bulach D, Tetteh CS, Prah I, van der Werf TS, Friedrich AW, Seemann T, van Dijl JM, Stienstra Y, Stinear TP, Rossen JW. Methicillin Resistant Staphylococcus aureus Transmission in a Ghanaian Burn Unit: The Importance of Active Surveillance in Resource-Limited Settings. Front Microbiol 2017; 8:1906. [PMID: 29056927 PMCID: PMC5635451 DOI: 10.3389/fmicb.2017.01906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 09/19/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives:Staphylococcus aureus infections in burn patients can lead to serious complications and death. The frequency of S. aureus infection is high in low- and middle-income countries presumably due to limited resources, misuse of antibiotics and poor infection control. The objective of the present study was to apply population genomics to precisely define, for the first time, the transmission of antibiotic resistant S. aureus in a resource-limited setting in sub-Saharan Africa. Methods:Staphylococcus aureus surveillance was performed amongst burn patients and healthcare workers during a 7-months survey within the burn unit of the Korle Bu Teaching Hospital in Ghana. Results: Sixty-six S. aureus isolates (59 colonizing and 7 clinical) were obtained from 31 patients and 10 healthcare workers. Twenty-one of these isolates were ST250-IV methicillin-resistant S. aureus (MRSA). Notably, 25 (81%) of the 31 patients carried or were infected with S. aureus within 24 h of admission. Genome comparisons revealed six distinct S. aureus clones circulating in the burn unit, and demonstrated multiple transmission events between patients and healthcare workers. Further, the collected S. aureus isolates exhibited a wide range of genotypic resistances to antibiotics, including trimethoprim (21%), aminoglycosides (33%), oxacillin (33%), chloramphenicol (50%), tetracycline (59%) and fluoroquinolones (100%). Conclusion: Population genomics uncovered multiple transmission events of S. aureus, especially MRSA, within the investigated burn unit. Our findings highlight lapses in infection control and prevention, and underscore the great importance of active surveillance to protect burn victims against multi-drug resistant pathogens in resource-limited settings.
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Affiliation(s)
- Nana Ama Amissah
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.,Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Andrew H Buultjens
- Department of Microbiology and Immunology, The Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Anthony Ablordey
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Lieke van Dam
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Ampomah Opoku-Ware
- Burns Unit, Reconstructive Plastic Surgery and Burns Unit, Korle Bu Teaching Hospital, Accra, Ghana
| | - Sarah L Baines
- Department of Microbiology and Immunology, The Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Dieter Bulach
- Department of Microbiology and Immunology, The Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Caitlin S Tetteh
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Isaac Prah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Tjip S van der Werf
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Alexander W Friedrich
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Torsten Seemann
- Victorian Bioinformatics Consortium, Monash University, Clayton, VIC, Australia
| | - Jan Maarten van Dijl
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Timothy P Stinear
- Department of Microbiology and Immunology, The Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - John W Rossen
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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31
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Lebughe M, Phaku P, Niemann S, Mumba D, Peters G, Muyembe-Tamfum JJ, Mellmann A, Strauß L, Schaumburg F. The Impact of the Staphylococcus aureus Virulome on Infection in a Developing Country: A Cohort Study. Front Microbiol 2017; 8:1662. [PMID: 28900424 PMCID: PMC5581934 DOI: 10.3389/fmicb.2017.01662] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 08/16/2017] [Indexed: 12/31/2022] Open
Abstract
We performed a cohort study to analyze the virulome of Staphylococcus aureus from the Democratic Republic of the Congo using whole genome sequencing and to assess its impact on the course of S. aureus infections. Community-associated S. aureus from nasal colonization (n = 100) and infection (n = 86) were prospectively collected. Phenotypic susceptibility testing and WGS was done for each isolate. WGS data were used to screen for 79 different virulence factors and for genotyping purposes (spa typing, multilocus sequence typing). The majority of the 79 virulence factors were equally distributed among isolates from colonization and infection. Panton-Valentine leukocidin (PVL) and the non-truncated hemolysin β were associated with skin and soft tissue infection (SSTI) and recurrence of disease but did not influence the course of infection (i.e., mortality, surgical intervention). For the first time, we show that not only PVL but also hemolysin β could contribute to the development of SSTI in PVL-endemic areas such as Africa.
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Affiliation(s)
- Marthe Lebughe
- Institut National de Recherche Bio-Médicale, Université de KinshasaKinshasa, Democratic Republic of the Congo
| | - Patrick Phaku
- Institut National de Recherche Bio-Médicale, Université de KinshasaKinshasa, Democratic Republic of the Congo
| | - Silke Niemann
- Institute of Medical Microbiology, University Hospital MünsterMünster, Germany
| | - Dieudonné Mumba
- Institut National de Recherche Bio-Médicale, Université de KinshasaKinshasa, Democratic Republic of the Congo
| | - Georg Peters
- Institute of Medical Microbiology, University Hospital MünsterMünster, Germany
| | - Jean-Jacques Muyembe-Tamfum
- Institut National de Recherche Bio-Médicale, Université de KinshasaKinshasa, Democratic Republic of the Congo
| | | | - Lena Strauß
- Institute of Hygiene, University Hospital MünsterMünster, Germany
| | - Frieder Schaumburg
- Institute of Medical Microbiology, University Hospital MünsterMünster, Germany
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Prevalence and Genetic Characteristics of Staphylococcus aureus and Staphylococcus argenteus Isolates Harboring Panton-Valentine Leukocidin, Enterotoxins, and TSST-1 Genes from Food Handlers in Myanmar. Toxins (Basel) 2017; 9:toxins9080241. [PMID: 28777321 PMCID: PMC5577575 DOI: 10.3390/toxins9080241] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 07/26/2017] [Accepted: 08/02/2017] [Indexed: 11/17/2022] Open
Abstract
Asymptomatic carriers of toxigenic Staphylococcus aureus are potential source of diseases, including food poisoning. Toxigenic potential and genetic traits of colonizing S. aureus were investigated for 563 healthy food handlers in Myanmar. Carriage of S. aureus was found in 110 individuals (19.5%), and a total of 144 S. aureus isolates were recovered from nasal cavities (110 isolates) and hands (34 isolates). Panton-Valentine leucocidin genes (pvl) were detected in 18 isolates (12.5%), among which 11 isolates were classified into coa-VIa, agr type III, and ST1930 (CC96) that had been also detected in pvl-positive clinical isolates in Myanmar. A pvl-positive, ST2250 nasal isolate was identified as S. argenteus, a novel coagulase-positive staphylococcus species. Toxic shock syndrome toxin-1 (TSST-1) gene was detected in five pvl-negative isolates. All of the 144 isolates harbored at least one of the 21 enterotoxin(-like) gene(s). The most prevalent enterotoxin(-like) gene was selw (98%), followed by selx (97%), sei (28%), sely (28%), sem (26%), sel (24%), and sea and sec (22% each). Considerable genetic diversity with five groups was detected for selw. The present study revealed the relatively high rate of pvl, as well as the wide distribution of enterotoxin(-like) genes among colonizing S. aureus in Myanmar.
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33
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Amissah NA, Chlebowicz MA, Ablordey A, Tetteh CS, Prah I, van der Werf TS, Friedrich AW, van Dijl JM, Stienstra Y, Rossen JW. Virulence potential of Staphylococcus aureus isolates from Buruli ulcer patients. Int J Med Microbiol 2017; 307:223-232. [PMID: 28442219 DOI: 10.1016/j.ijmm.2017.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/01/2017] [Accepted: 04/13/2017] [Indexed: 12/27/2022] Open
Abstract
Buruli ulcer (BU) is a necrotizing infection of the skin and subcutaneous tissue caused by Mycobacterium ulcerans. BU wounds may also be colonized with other microorganisms including Staphylococcus aureus. This study aimed to characterize the virulence factors of S. aureus isolated from BU patients. Previously sequenced genomes of 21 S. aureus isolates from BU patients were screened for the presence of virulence genes. The results show that all S. aureus isolates harbored on their core genomes genes for known virulence factors like α-hemolysin, and the α- and β-phenol soluble modulins. Besides the core genome virulence genes, mobile genetic elements (MGEs), i.e. prophages, genomic islands, pathogenicity islands and a Staphylococcal cassette chromosome (SCC) were found to carry different combinations of virulence factors, among them genes that are known to encode factors that promote immune evasion, superantigens and Panton-Valentine Leucocidin. The present observations imply that the S. aureus isolates from BU patients harbor a diverse repertoire of virulence genes that may enhance bacterial survival and persistence in the wound environment and potentially contribute to delayed wound healing.
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Affiliation(s)
- Nana Ama Amissah
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
| | - Monika A Chlebowicz
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anthony Ablordey
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Caitlin S Tetteh
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Isaac Prah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Tjip S van der Werf
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alex W Friedrich
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan Maarten van Dijl
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - John W Rossen
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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34
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Ruffing U, Alabi A, Kazimoto T, Vubil DC, Akulenko R, Abdulla S, Alonso P, Bischoff M, Germann A, Grobusch MP, Helms V, Hoffmann J, Kern WV, Kremsner PG, Mandomando I, Mellmann A, Peters G, Schaumburg F, Schubert S, Strauß L, Tanner M, Briesen HV, Wende L, Müller LV, Herrmann M. Community-Associated Staphylococcus aureus from Sub-Saharan Africa and Germany: A Cross-Sectional Geographic Correlation Study. Sci Rep 2017; 7:154. [PMID: 28273954 PMCID: PMC5428059 DOI: 10.1038/s41598-017-00214-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 02/14/2017] [Indexed: 01/29/2023] Open
Abstract
Clonal clusters and gene repertoires of Staphylococcus aureus are essential to understand disease and are well characterized in industrialized countries but poorly analysed in developing regions. The objective of this study was to compare the molecular-epidemiologic profiles of S. aureus isolates from Sub-Saharan Africa and Germany. S. aureus isolates from 600 staphylococcal carriers and 600 patients with community-associated staphylococcal disease were characterized by DNA hybridization, clonal complex (CC) attribution, and principal component (PCA)-based gene repertoire analysis. 73% of all CCs identified representing 77% of the isolates contained in these CCs were predominant in either African or German region. Significant differences between African versus German isolates were found for alleles encoding the accessory gene regulator type, enterotoxins, the Panton-Valentine leukocidin, immune evasion gene cluster, and adhesins. PCA in conjunction with silhouette analysis distinguished nine separable PCA clusters, with five clusters primarily comprising of African and two clusters of German isolates. Significant differences between S. aureus lineages in Africa and Germany may be a clue to explain the apparent difference in disease between tropical/(so-called) developing and temperate/industrialized regions. In low-resource countries further clinical-epidemiologic research is warranted not only for neglected tropical diseases but also for major bacterial infections.
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Affiliation(s)
- Ulla Ruffing
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Abraham Alabi
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon
| | - Theckla Kazimoto
- Ifakara Health Research and Development Centre (IHRDC), Dar es Salaam, Tanzania
| | - Delfino C Vubil
- Manhiça Health Research Center, Manhiça, Manhiça, Mozambique
| | - Ruslan Akulenko
- Center for Bioinformatics, Saarland University, Saarbrücken, Germany
| | - Salim Abdulla
- Ifakara Health Research and Development Centre (IHRDC), Dar es Salaam, Tanzania
| | - Pedro Alonso
- Manhiça Health Research Center, Manhiça, Manhiça, Mozambique.,Department of Public Health, University of Barcelona, Barcelona, Spain
| | - Markus Bischoff
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Anja Germann
- Fraunhofer Institute for Biomedical Engineering, St. Ingbert, Germany
| | - Martin P Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon.,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Volkhard Helms
- Center for Bioinformatics, Saarland University, Saarbrücken, Germany
| | - Jonas Hoffmann
- Division of Infectious Diseases and Travel Medicine, University of Freiburg, Freiburg, Germany
| | - Winfried V Kern
- Division of Infectious Diseases and Travel Medicine, University of Freiburg, Freiburg, Germany
| | - Peter G Kremsner
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon.,Institute of Tropical Medicine, University of Tübingen, Deutsches Zentrum für Infektionsforschung, Tübingen, Germany
| | | | | | - Georg Peters
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Frieder Schaumburg
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Sabine Schubert
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Lena Strauß
- Institute of Hygiene, University Hospital Münster, Münster, Germany
| | - Marcel Tanner
- Ifakara Health Research and Development Centre (IHRDC), Dar es Salaam, Tanzania.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Hagen von Briesen
- Fraunhofer Institute for Biomedical Engineering, St. Ingbert, Germany
| | - Laura Wende
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Lutz von Müller
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Mathias Herrmann
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
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Vandendriessche S, De Boeck H, Deplano A, Phoba MF, Lunguya O, Falay D, Dauly N, Verhaegen J, Denis O, Jacobs J. Characterisation of Staphylococcus aureus isolates from bloodstream infections, Democratic Republic of the Congo. Eur J Clin Microbiol Infect Dis 2017; 36:1163-1171. [PMID: 28116552 DOI: 10.1007/s10096-017-2904-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/09/2017] [Indexed: 01/12/2023]
Abstract
Staphylococcus aureus is known worldwide as an invasive pathogen, but information on S. aureus from bloodstream infections in Central Africa remains scarce. A collection of S. aureus blood culture isolates recovered from hospitals in four provinces in the Democratic Republic of the Congo (2009-2013) was assessed. A total of 27/108 isolates were methicillin-resistant S. aureus (MRSA), of which >70% were co-resistant to aminoglycosides, tetracyclines, macrolides and lincosamides. For MRSA and methicillin-susceptible S. aureus (MSSA) isolates, resistance to chloramphenicol and trimethoprim-sulphamethoxazole (TMP-SMX) was <10%. However, 66.7% (72/108) of all isolates harboured the trimethoprim resistance gene dfrG. More than three-quarters (84/108, 77.8%) of isolates belonged to CC5, CC8, CC121 or CC152. Genetic diversity was higher among MSSA (31 spa types) compared to MRSA (four spa types). Most MRSA (23/27, 85.2%) belonged to CC8-spa t1476-SCCmec V and 17/23 (73.9%) MRSA ST8 were oxacillin susceptible but cefoxitin resistant. Among MRSA and MSSA combined, 49.1% (53/108) and 19.4% (21/108) contained the genes encoding for Panton-Valentine leucocidin (lukS-lukF PV, PVL) and toxic shock syndrome toxin-1 (tst, TSST-1), respectively. PVL was mainly detected among MSSA (51/53 isolates harbouring PVL were MSSA, 96.2%) and associated with CC121, CC152, CC1 and CC5. TSST-1 was associated with CC8-spa t1476-SCCmec V. The immune evasion cluster (IEC) genes scn, sak and chp were detected in 81.5% of isolates (88/108, equally represented among MSSA and MRSA). The present study confirms the occurrence of MRSA with high levels of multidrug co-resistance and PVL-positive MSSA among invasive S. aureus isolates in Central Africa.
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Affiliation(s)
- S Vandendriessche
- National Reference Centre for Staphylococcus aureus, Laboratory of Microbiology, Université Libre de Bruxelles (ULB), Brussels, Belgium.
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.
| | - H De Boeck
- Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | - A Deplano
- National Reference Centre for Staphylococcus aureus, Laboratory of Microbiology, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - M-F Phoba
- Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | - O Lunguya
- Department of Clinical Microbiology, National Institute for Biomedical Research Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
- Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - D Falay
- Department of Pediatrics, University Hospital of Kisangani, Kisangani, Democratic Republic of the Congo
| | - N Dauly
- Department of Clinical Microbiology, National Institute for Biomedical Research Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
- Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - J Verhaegen
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - O Denis
- National Reference Centre for Staphylococcus aureus, Laboratory of Microbiology, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - J Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
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Asiimwe BB, Baldan R, Trovato A, Cirillo DM. Molecular epidemiology of Panton-Valentine Leukocidin-positive community-acquired methicillin resistant Staphylococcus aureus isolates in pastoral communities of rural south western Uganda. BMC Infect Dis 2017; 17:24. [PMID: 28056833 PMCID: PMC5216539 DOI: 10.1186/s12879-016-2124-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 12/14/2016] [Indexed: 11/30/2022] Open
Abstract
Background The emergence of multidrug resistant Staphylococcus aureus strains, including methicillin resistant (MRSA), is a global concern. Treatment of bacterial infections in Uganda’s health care settings is largely empirical, rarely accompanied by laboratory confirmation. Here we show the burden, characteristics of MRSA and epidemiology of Panton-Valentine Leukocidin (PVL) positive strains in asymptomatic carriers in pastoral households of south-west Uganda. Methods Nasal swabs from 253 participants were cultured following standard methodology. MRSA strains were identified by detection of the mecA gene and SCCmec typing, and PVL genes detected by PCR. Pulsed Field Gel Electrophoresis (PFGE) was done to evaluate possible transmission patterns. Spa typing of PVL positive isolates was done to study the epidemiology of virulent strains in this setting. Results S. aureus was isolated in 29% (n = 73) of the participants, of which 48 were MRSA by mecA typing. PVL-encoding genes were found in 49.3% (n = 36) of the 73 isolates, of which 25 were also mecA positive. Among the PVL negative strains (n = 37), 62.2% (n = 23) carried the mecA gene. The most common SCCmec type was V, detected in 39 (18 PVL positive and 21 PVL negative) isolates. PFGE clustered 21/36 (58.3%) PVL positive isolates divided in four pulsotypes and 18/37 (48.6%) PVL negative isolates divided in eight pulsotypes. The most prevalent Spa types were t318 (26.5%, n = 9) and t645 (20.6%, n = 7); while other common Spa types were t11656 (n = 3), t127 (n = 3) and t355 (n = 3). Conclusion The study shows a high prevalence of community acquired (CA)-MRSA, and PVL-positive isolates with two predominant spa types in rural Uganda, further complicating infection control strategies in these underprivileged communities.
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Affiliation(s)
- Benon B Asiimwe
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, Milano, Italy. .,Universita Vita-Salute San Raffaele, Via Olgettina 58, Milano, Italy. .,Department of Medical Microbiology, Makerere University College of Health Sciences, P. O. Box 7072, Kampala, Uganda.
| | - Rossella Baldan
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, Milano, Italy
| | - Alberto Trovato
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, Milano, Italy
| | - Daniela M Cirillo
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, Milano, Italy.,Universita Vita-Salute San Raffaele, Via Olgettina 58, Milano, Italy
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37
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Dekker D, Wolters M, Mertens E, Boahen KG, Krumkamp R, Eibach D, Schwarz NG, Adu-Sarkodie Y, Rohde H, Christner M, Marks F, Sarpong N, May J. Antibiotic resistance and clonal diversity of invasive Staphylococcus aureus in the rural Ashanti Region, Ghana. BMC Infect Dis 2016; 16:720. [PMID: 27899074 PMCID: PMC5129674 DOI: 10.1186/s12879-016-2048-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/18/2016] [Indexed: 01/23/2023] Open
Abstract
Background Staphylococcus aureus is among the most common pathogens isolated from blood cultures in Ghana; yet the epidemiology of blood infections in rural settings is poorly described. This study aims to investigate antimicrobial susceptibility and clonal diversity of S. aureus causing bloodstream infections in two hospitals in the Ashanti Region, Ghana. Methods Blood cultures were performed for all febrile patients (≥37.5 °C) on hospital admission. Antibiotic susceptibility testing for S. aureus isolates was carried out by the VITEK 2 system. Multiplex polymerase chain reaction (PCR) was used to detect S. aureus-specific nuc gene, Panton-Valentine leukocidin (PVL), and methicillin-resistant S. aureus (MRSA)-specific mecA and mecC genes. The population structure of S. aureus was assessed by spa typing. Results In total, 9,834 blood samples were cultured, out of which 0.6% (n = 56) were positive for S. aureus. Multidrug resistance (MDR) was detected in 35.7% (n = 20) of the S. aureus strains, of which one was a MRSA. The highest rate of antibiotic resistance was seen for commonly available antibiotics, including penicillin (n = 55; 98.2%), tetracycline (n = 32; 57.1%) and trimethoprim/sulfamethoxazole (n = 26; 46.4%). Of all S. aureus strains, 75.0% (n = 42) carried the PVL-encoding genes. We found 25 different spa types with t355 (n = 11; 19.6%), t314 (n = 8; 14.3%), t084 (n = 8; 14.3%) and t311 (n = 5; 8.9%) being predominant. Conclusion The study exhibited an alarmingly large level of antibiotic resistance to locally available antibiotics. The frequency of genetically diverse and PVL-positive methicillin-sensitive S. aureus (MSSA) was high and could represent a reservoir for the emergence of virulent PVL-positive MRSA clones.
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Affiliation(s)
- Denise Dekker
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Research Group Infectious Disease Epidemiology, Bernhard-Nocht-Str. 74, D-20359, Hamburg, Germany. .,German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Hamburg, Germany.
| | - Manuel Wolters
- University Medical Centre Hamburg-Eppendorf (UKE), Martinistr.52, D-20246, Hamburg, Germany
| | - Eva Mertens
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Research Group Infectious Disease Epidemiology, Bernhard-Nocht-Str. 74, D-20359, Hamburg, Germany.,German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Hamburg, Germany
| | - Kennedy Gyau Boahen
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Ralf Krumkamp
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Research Group Infectious Disease Epidemiology, Bernhard-Nocht-Str. 74, D-20359, Hamburg, Germany.,German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Hamburg, Germany
| | - Daniel Eibach
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Research Group Infectious Disease Epidemiology, Bernhard-Nocht-Str. 74, D-20359, Hamburg, Germany
| | - Norbert G Schwarz
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Research Group Infectious Disease Epidemiology, Bernhard-Nocht-Str. 74, D-20359, Hamburg, Germany
| | - Yaw Adu-Sarkodie
- Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Holger Rohde
- University Medical Centre Hamburg-Eppendorf (UKE), Martinistr.52, D-20246, Hamburg, Germany
| | - Martin Christner
- University Medical Centre Hamburg-Eppendorf (UKE), Martinistr.52, D-20246, Hamburg, Germany
| | - Florian Marks
- International Vaccine Institute (IVI), Seoul, Republic of Korea
| | - Nimako Sarpong
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Jürgen May
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Research Group Infectious Disease Epidemiology, Bernhard-Nocht-Str. 74, D-20359, Hamburg, Germany.,German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Hamburg, Germany
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Ouedraogo AS, Dunyach-Remy C, Kissou A, Sanou S, Poda A, Kyelem CG, Solassol J, Bañuls AL, Van De Perre P, Ouédraogo R, Jean-Pierre H, Lavigne JP, Godreuil S. High Nasal Carriage Rate of Staphylococcus aureus Containing Panton-Valentine leukocidin- and EDIN-Encoding Genes in Community and Hospital Settings in Burkina Faso. Front Microbiol 2016; 7:1406. [PMID: 27679613 PMCID: PMC5020597 DOI: 10.3389/fmicb.2016.01406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 08/24/2016] [Indexed: 12/13/2022] Open
Abstract
The objectives of the present study were to investigate the rate of S.aureus nasal carriage and molecular characteristics in hospital and community settings in Bobo Dioulasso, Burkina Faso. Nasal samples (n = 219) were collected from 116 healthy volunteers and 103 hospitalized patients in July and August 2014. Samples were first screened using CHROMagar Staph aureus chromogenic agar plates, and S. aureus strains were identified by mass spectrometry. Antibiotic susceptibility was tested using the disk diffusion method on Müller-Hinton agar. All S. aureus isolates were genotyped using DNA microarray. Overall, the rate of S. aureus nasal carriage was 32.9% (72/219) with 29% in healthy volunteers and 37% in hospital patients. Among the S. aureus isolates, only four methicillin-resistant S. aureus (MRSA) strains were identified and all in hospital patients (3.9%). The 72 S. aureus isolates from nasal samples belonged to 16 different clonal complexes, particularly to CC 152-MSSA (22 clones) and CC1-MSSA (nine clones). Two clones were significantly associated with community settings: CC1-MSSA and CC45-MSSA. The MRSA strains belonged to the ST88-MRSA-IV or the CC8-MRSA-V complex. A very high prevalence of toxinogenic strains 52.2% (36/69), containing Panton-Valentine leucocidin- and EDIN-encoding genes, was identified among the S. aureus isolates in community and hospital settings. This study provides the first characterization of S. aureus clones and their genetic characteristics in Burkina Faso. Altogether, it highlights the low prevalence of antimicrobial resistance, high diversity of methicillin-sensitive S. aureus clones and high frequency of toxinogenic S. aureus strains.
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Affiliation(s)
- Abdoul-Salam Ouedraogo
- Centre Hospitalier Universitaire Souro SanouBobo Dioulasso, Burkina Faso; Département de Bactériologie-Virologie, Centre Hospitalier Universitaire de MontpellierMontpellier, France; Université de MontpellierMontpellier, France; Institut National de la Santé et de la Recherche Médicale U1058, Infection by HIV and by Agents with Mucocutaneous Tropism: From Pathogenesis to PreventionMontpellier, France
| | - Catherine Dunyach-Remy
- Institut National de la Santé et de la Recherche Médicale U1047, Université de MontpellierNîmes, France; Service de Microbiologie, Centre Hospitalier Universitaire CaremeauNîmes, France
| | - Aimée Kissou
- Centre Hospitalier Universitaire Souro Sanou Bobo Dioulasso, Burkina Faso
| | - Soufiane Sanou
- Centre Hospitalier Universitaire Souro Sanou Bobo Dioulasso, Burkina Faso
| | - Armel Poda
- Centre Hospitalier Universitaire Souro Sanou Bobo Dioulasso, Burkina Faso
| | - Carole G Kyelem
- Centre Hospitalier Universitaire Souro Sanou Bobo Dioulasso, Burkina Faso
| | - Jérôme Solassol
- Department of Biopathology, Centre Hospitalier Universitaire MontpellierMontpellier, France; Department of Clinical Oncoproteomics, Montpellier Cancer InstituteMontpellier, France
| | - Anne-Laure Bañuls
- UMR MIVEGEC (IRD 224 - Centre National de la Recherche Scientifique 5290 - Université de Montpellier) Montpellier, France
| | - Philippe Van De Perre
- Département de Bactériologie-Virologie, Centre Hospitalier Universitaire de MontpellierMontpellier, France; Université de MontpellierMontpellier, France; Institut National de la Santé et de la Recherche Médicale U1058, Infection by HIV and by Agents with Mucocutaneous Tropism: From Pathogenesis to PreventionMontpellier, France
| | - Rasmata Ouédraogo
- Centre Hospitalier Universitaire Souro Sanou Bobo Dioulasso, Burkina Faso
| | - Hélène Jean-Pierre
- Département de Bactériologie-Virologie, Centre Hospitalier Universitaire de Montpellier Montpellier, France
| | - Jean-Philippe Lavigne
- Institut National de la Santé et de la Recherche Médicale U1047, Université de MontpellierNîmes, France; Service de Microbiologie, Centre Hospitalier Universitaire CaremeauNîmes, France
| | - Sylvain Godreuil
- Département de Bactériologie-Virologie, Centre Hospitalier Universitaire de MontpellierMontpellier, France; Université de MontpellierMontpellier, France; Institut National de la Santé et de la Recherche Médicale U1058, Infection by HIV and by Agents with Mucocutaneous Tropism: From Pathogenesis to PreventionMontpellier, France
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Molecular epidemiology of Staphylococcus aureus from Lambaréné, Gabon. Eur J Clin Microbiol Infect Dis 2016; 35:1963-1973. [PMID: 27553495 DOI: 10.1007/s10096-016-2748-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/03/2016] [Indexed: 12/12/2022]
Abstract
While there is an abundance of data on the epidemiology and molecular typing of Staphylococcus aureus, especially those carrying Panton-Valentine leucocidin (PVL) genes or mecA from Western Europe, Northern America and Australia, comparably few studies target African strains. In this study, we characterised genes associated with virulence and resistance, as well the phylogenetic background of S. aureus from healthy carriers and outpatients in Gabon. In total, 103 isolates from 96 study participants were characterised. Seventy-nine isolates originated from throat swabs and 24 isolates from skin lesions. Three isolates carried mecA, although only one, belonging to CC8-MRSA-IV [PVL+] 'USA300', was found to be phenotypically oxacillin-resistant; two CC88-MRSA-IV isolates appeared to be oxacillin-susceptible. PVL genes were common, with a total of 44 isolates (43 %) found to be PVL-positive. CC15-MSSA [PVL+] (n = 29) and CC152-MSSA [PVL+] (n = 9) were the predominant clones among the PVL-positive isolates. Among PVL-negative isolates, CC5-MSSA (n = 12), CC101-MSSA (n = 10) and CC15 (n = 9) were the most frequent. A hitherto undescribed multilocus sequence type of S. schweitzeri was detected twice in unrelated patients. The data emphasise a need for further studies on the role of PVL in African populations and the clinical significance of S. schweitzeri.
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40
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Hogan B, Rakotozandrindrainy R, Al-Emran H, Dekker D, Hahn A, Jaeger A, Poppert S, Frickmann H, Hagen RM, Micheel V, Crusius S, Heriniaina JN, Rakotondrainiarivelo JP, Razafindrabe T, May J, Schwarz NG. Prevalence of nasal colonisation by methicillin-sensitive and methicillin-resistant Staphylococcus aureus among healthcare workers and students in Madagascar. BMC Infect Dis 2016; 16:420. [PMID: 27526771 PMCID: PMC4986198 DOI: 10.1186/s12879-016-1733-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) clones pose a significant threat to hospitalised patients because the bacteria can be transmitted by asymptomatic carriers within healthcare facilities. To date, nothing is known about the prevalence of S. aureus and MRSA among healthcare workers in Madagascar. The objective of our study was to examine the prevalence and clonal epidemiology of nasal S. aureus and MRSA among healthcare workers and non-medical University students in Antananarivo, Madagascar. METHODS This cross sectional study screened nasal swabs taken from students and healthcare workers for S. aureus. Multiplex PCR was performed to identify S. aureus-specific (nuc), MRSA-specific mecA and mecC genes, Panton-Valentine leukocidin (PVL) (lukF-PV), and toxic shock syndrome toxin-1 (TSST-1) specific genes in methicillin-sensitive S. aureus (MSSA) and MRSA isolates. Staphylococcus protein A gene (spa) typing was performed for all confirmed MRSA isolates. The frequency distribution of nasal S. aureus and MRSA of healthcare workers and non-medical students was compared using Pearson's χ(2) test. RESULTS Of 1548 nasal swabs tested, 171 (11 %) were positive for S. aureus; 20 (1.3 %) of these isolates were identified as MRSA. S. aureus was detected in 91 of 863 healthcare workers (10.4 %) and in 80 (11.8 %) of 685 students; however, 14 (1.5 %) healthcare workers carried MRSA compared with six (0.9 %) students. Nasal carriage of S. aureus and MRSA was more prevalent in women than in men, and 21 (11.7 %) S. aureus isolates were PVL-positive and 36 (21 %) were TSST-1 positive. The mecC gene was not detected in any isolates. Five different spa types were identified, with spa type t186 being the predominant MRSA clone (16/20). CONCLUSION The results of the present study reveal a low frequency of S. aureus and MRSA nasal carriage in both students and healthcare workers from Antananarivo, Madagascar. The predominant MRSA clone (t186) was previously described in hospitalised patients in Madagascar.
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Affiliation(s)
- Benedikt Hogan
- Research Group Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, D-20359 Hamburg, Germany
| | | | - Hassan Al-Emran
- Research Group Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, D-20359 Hamburg, Germany
| | - Denise Dekker
- Research Group Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, D-20359 Hamburg, Germany
| | - Andreas Hahn
- Research Group Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, D-20359 Hamburg, Germany
| | - Anna Jaeger
- Research Group Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, D-20359 Hamburg, Germany
| | - Sven Poppert
- University Medical Center, Hamburg-Eppendorf, Martinistr. 52, 20251 Hamburg, Germany
| | - Hagen Frickmann
- Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital of Hamburg, Bernhard-Nocht-Str. 74, D-20359 Hamburg, Germany
- Institute for Medical Microbiology, Virology and Hygiene, University Hospital of Rostock, Schillingallee 70, D-18057 Rostock, Germany
| | - Ralf Matthias Hagen
- Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital of Hamburg, Bernhard-Nocht-Str. 74, D-20359 Hamburg, Germany
| | - Volker Micheel
- Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital of Hamburg, Bernhard-Nocht-Str. 74, D-20359 Hamburg, Germany
| | - Sabine Crusius
- Institute for Medical Microbiology, Virology and Hygiene, University Hospital of Rostock, Schillingallee 70, D-18057 Rostock, Germany
| | - Jean Noel Heriniaina
- Department of Microbiology and Parasitology, University of Antananarivo, B.P. 175, Antananarivo, Madagascar
| | | | - Tsiriniaina Razafindrabe
- Department of Microbiology and Parasitology, University of Antananarivo, B.P. 175, Antananarivo, Madagascar
| | - Jürgen May
- Research Group Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, D-20359 Hamburg, Germany
| | - Norbert Georg Schwarz
- Research Group Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, D-20359 Hamburg, Germany
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Jaton L, Pillonel T, Jaton K, Dory E, Prod'hom G, Blanc DS, Tissot F, Bodenmann P, Greub G. Common skin infection due to Panton-Valentine leucocidin-producing Staphylococcus aureus strains in asylum seekers from Eritrea: a genome-based investigation of a suspected outbreak. Clin Microbiol Infect 2016; 22:739.e5-8. [PMID: 27283147 DOI: 10.1016/j.cmi.2016.05.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/09/2016] [Accepted: 05/28/2016] [Indexed: 01/14/2023]
Abstract
Since late 2014, multiple cases of abscesses and boils due to methicillin-susceptible Staphylococcus aureus (MSSA) expressing the Panton-Valentine leucocidin (PVL) were observed in Eritrean asylum seekers in Lausanne, Switzerland. Strains isolated from infected Eritrean and non-Eritrean patients were compared by whole genome sequencing to determine whether these numerous cases result from an outbreak. The genome of S. aureus PVL-producing strains were sequenced and compared. Clinical and epidemiological characteristics of patients infected by PVL-producing strains were investigated. This work reports 15 cases of infections due to PVL-producing strains affecting mostly asylum seekers (n = 10), people working with refugees and/or exposed to Africans (n = 3). Most infections were due to closely related strains of CC152 (n = 8) and CC15 (n = 3), two distantly related (>34 000 core single nucleotide polymorphisms) clonal complexes. An epidemiological link between the 15 cases could be ruled out by whole genome sequencing (33 to 172 core single nucleotide polymorphisms between the different strains of a given complex). Altogether, these results reflect the probable high incidence of CC15 and CC152 PVL-producing strains in eastern Africa. Clinicians facing unusual skin infections in African refugees (or in any person returning from this region of high endemicity) should consider S. aureus PVL-producer before suspecting rare infections such as leishmaniasis or rickettsiosis. Clinicians should also remember that PVL are frequently expressed by MSSA in some regions of the world and that antibiotics that are efficient on toxin expression, such as clindamycin, represent the best therapeutic option.
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Affiliation(s)
- L Jaton
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| | - T Pillonel
- Institute of Microbiology, University of Lausanne and University Hospital of Lausanne, Lausanne, Switzerland
| | - K Jaton
- Institute of Microbiology, University of Lausanne and University Hospital of Lausanne, Lausanne, Switzerland
| | - E Dory
- Vulnerable Population Centre, Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| | - G Prod'hom
- Institute of Microbiology, University of Lausanne and University Hospital of Lausanne, Lausanne, Switzerland
| | - D S Blanc
- Service of Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland
| | - F Tissot
- Infectious Diseases Service, University Hospital of Lausanne, Lausanne, Switzerland
| | - P Bodenmann
- Vulnerable Population Centre, Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
| | - G Greub
- Institute of Microbiology, University of Lausanne and University Hospital of Lausanne, Lausanne, Switzerland.
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42
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Madzgalla S, Syed MA, Khan MA, Rehman SS, Müller E, Reissig A, Ehricht R, Monecke S. Molecular characterization of Staphylococcus aureus isolates causing skin and soft tissue infections in patients from Malakand, Pakistan. Eur J Clin Microbiol Infect Dis 2016; 35:1541-7. [PMID: 27262852 DOI: 10.1007/s10096-016-2695-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 05/24/2016] [Indexed: 11/24/2022]
Abstract
Comparatively few studies have been published describing Staphylococcus aureus/MRSA epidemiology in Central Asia including Pakistan. Here, we report the genotyping of Staphylococcus aureus strains (that include both methicillin-susceptible and methicillin-resistant Staphylococcus aureus) from community- and hospital-acquired skin and soft-tissue infections in a tertiary care hospital in the Malakand district of the Khyber Pakhtunkhwa Province of Pakistan. Forty-five isolates of Staphylococcus aureus were characterized by microarray hybridization. Twenty isolates (44 %) were MRSA, whereas 22 (49 %) were PVL-positive. Fourteen isolates (31 %) harboured both mecA and PVL genes. The dominant clones were CC121-MSSA (n = 15, 33 %) and the PVL-positive "Bengal Bay Clone" (ST772-MRSA-V; n = 13, 29 %). The PVL-positive CC8-MRSA-IV strain "USA300" was found once. The pandemic ST239-MRSA-III strain was absent, although it has previously been observed in Pakistan. These observations require a re-assessment of schemes for initial antibiotic therapy to cover MRSA and they emphasise the need for a rapid and non-molecular test for PVL.
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Affiliation(s)
- S Madzgalla
- Alere Technologies GmbH, Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - M A Syed
- Infectious Diseases Research Group, Department of Microbiology, University of Haripur, Haripur, Pakistan
| | - M A Khan
- Infectious Diseases Research Group, Department of Microbiology, University of Haripur, Haripur, Pakistan
| | - S S Rehman
- Infectious Diseases Research Group, Department of Microbiology, University of Haripur, Haripur, Pakistan
| | - E Müller
- Alere Technologies GmbH, Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - A Reissig
- Alere Technologies GmbH, Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - R Ehricht
- Alere Technologies GmbH, Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - S Monecke
- Alere Technologies GmbH, Jena, Germany. .,Institute for Medical Microbiology and Hygiene, Technische Universität Dresden, Dresden, Germany. .,InfectoGnostics Research Campus, Jena, Germany.
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43
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Whole-Genome Sequencing for Routine Pathogen Surveillance in Public Health: a Population Snapshot of Invasive Staphylococcus aureus in Europe. mBio 2016; 7:mBio.00444-16. [PMID: 27150362 PMCID: PMC4959656 DOI: 10.1128/mbio.00444-16] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The implementation of routine whole-genome sequencing (WGS) promises to transform our ability to monitor the emergence and spread of bacterial pathogens. Here we combined WGS data from 308 invasive Staphylococcus aureus isolates corresponding to a pan-European population snapshot, with epidemiological and resistance data. Geospatial visualization of the data is made possible by a generic software tool designed for public health purposes that is available at the project URL (http://www.microreact.org/project/EkUvg9uY?tt=rc). Our analysis demonstrates that high-risk clones can be identified on the basis of population level properties such as clonal relatedness, abundance, and spatial structuring and by inferring virulence and resistance properties on the basis of gene content. We also show that in silico predictions of antibiotic resistance profiles are at least as reliable as phenotypic testing. We argue that this work provides a comprehensive road map illustrating the three vital components for future molecular epidemiological surveillance: (i) large-scale structured surveys, (ii) WGS, and (iii) community-oriented database infrastructure and analysis tools. The spread of antibiotic-resistant bacteria is a public health emergency of global concern, threatening medical intervention at every level of health care delivery. Several recent studies have demonstrated the promise of routine whole-genome sequencing (WGS) of bacterial pathogens for epidemiological surveillance, outbreak detection, and infection control. However, as this technology becomes more widely adopted, the key challenges of generating representative national and international data sets and the development of bioinformatic tools to manage and interpret the data become increasingly pertinent. This study provides a road map for the integration of WGS data into routine pathogen surveillance. We emphasize the importance of large-scale routine surveys to provide the population context for more targeted or localized investigation and the development of open-access bioinformatic tools to provide the means to combine and compare independently generated data with publicly available data sets.
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44
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Ebruke C, Dione MM, Walter B, Worwui A, Adegbola RA, Roca A, Antonio M. High genetic diversity of Staphylococcus aureus strains colonising the nasopharynx of Gambian villagers before widespread use of pneumococcal conjugate vaccines. BMC Microbiol 2016; 16:38. [PMID: 26969294 PMCID: PMC4788959 DOI: 10.1186/s12866-016-0661-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 03/02/2016] [Indexed: 11/29/2022] Open
Abstract
Background With the global efforts of reducing pneumococcal disease through widespread introduction of pneumococcal vaccines, concerns have emerged on the potential increase of morbidity and mortality from S. aureus disease. Little is known however, of the carriage rates of S. aureus or of its’ relationship with carriage of S. pneumoniae in rural Africa, and West Africa in particular where very high rates of carriage of S. pneumoniae have been reported. This study aims to evaluate the prevalence, antibiotic susceptibility patterns and genotypes of S. aureus isolated from the nasopharynx of healthy individuals in rural Gambia before the introduction of routine use of pneumococcal conjugate vaccines in the country. Results Overall prevalence of S. aureus nasopharyngeal carriage was 25.2 %. All S. aureus isolates tested were susceptible to methicillin. Resistant was observed for sulphamethoxazole-trimethoprim (15 %) and tetracycline (34.3 %). We found 59 different sequence types (ST), 35 of which were novel. The most prevalent sequence types were ST 15 (28 %) and ST 5 (4 %). Eighty two percent (494/600) of study individuals were S. pneumoniae carriers with S. pneumoniae carriage rates decreasing with increasing age groups. S. aureus carriage among pneumococcal carriers was slightly lower than among non-pneumococcal carriers (24.3 versus 29.3 %; p = 0.324). There were no associations of carriage between these two bacteria across the 4 age groups. However, analysis of pooled data children < 2 years and children 2 to < 5 years of age showed a statistically significant inverse association (24.1 and 50.0 % for S. aureus carriage among S. pneumoniae carriers and non-carriers respectively; p = 0.015). Conclusions We report that nasopharyngeal carriage of S. aureus in rural Gambia is high in all age groups, with approximately 1 out of 4 individuals being carriers in the pre-pneumococcal vaccination era. There are indications that nasopharyngeal carriage of S.aureus could be inversely related to carriage of S. pneumoniae amongst younger children in The Gambian and that S. aureus clones in The Gambia show significant genetic diversity suggesting worldwide dissemination. Findings from this study provide a useful background for impact studies evaluating the introduction of pneumococcal vaccines or other interventions targeting the control of S. aureus infections and disease.
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Affiliation(s)
- Chinelo Ebruke
- Vaccine and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia.,Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Michel M Dione
- Vaccine and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | - Brigitte Walter
- Vaccine and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | - Archibald Worwui
- Vaccine and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | | | - Anna Roca
- Disease Control and Elimination, Medical Research Council Unit, Banjul, The Gambia
| | - Martin Antonio
- Vaccine and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia. .,Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK. .,Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK.
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Mehraj J, Witte W, Akmatov MK, Layer F, Werner G, Krause G. Epidemiology of Staphylococcus aureus Nasal Carriage Patterns in the Community. Curr Top Microbiol Immunol 2016; 398:55-87. [PMID: 27370344 DOI: 10.1007/82_2016_497] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
Staphylococcus aureus (S. aureus) is a Gram-positive opportunistic pathogen that colonizes frequently and asymptomatically the anterior nares of humans and animals. It can cause different kinds of infections and is considered to be an important nosocomial pathogen. Nasal carriage of S. aureus can be permanent or intermittent and may build the reservoir for autogenous infections and cross-transmission to other individuals. Most of the studies on the epidemiology of S. aureus performed in the past were focused on the emergence and dissemination of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare settings. There are, however, a number of more recent epidemiological studies have aimed at analysing carriage patterns over time in the community settings providing new insights on risk factors for colonization and important data for the development of strategies to prevent infections. This chapter aims to give a review of current epidemiological studies on S. aureus carriage patterns in the general community and put them into perspective with recent, yet unpublished, investigations on the S. aureus epidemiology in the general population in northern Germany.
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Affiliation(s)
- Jaishri Mehraj
- Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstraße 7, 38124, Brunswick, Germany.,Hannover Medical School, Hannover, Germany
| | - Wolfgang Witte
- The Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
| | - Manas K Akmatov
- Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstraße 7, 38124, Brunswick, Germany.,TWINCORE Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Franziska Layer
- The Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
| | - Guido Werner
- The Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstraße 7, 38124, Brunswick, Germany. .,Hannover Medical School, Hannover, Germany.
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46
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Rao Q, Shang W, Hu X, Rao X. Staphylococcus aureus ST121: a globally disseminated hypervirulent clone. J Med Microbiol 2015; 64:1462-1473. [PMID: 26445995 DOI: 10.1099/jmm.0.000185] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Staphylococcus aureus is a leading cause of bacterial infections in hospitals and communities worldwide. With the development of typing methods, several pandemic clones have been well characterized, including the extensively spreading hospital-associated meticillin-resistant S. aureus (HA-MRSA) clone ST239 and the emerging hypervirulent community-associated (CA) MRSA clone USA300. The multilocus sequence typing method was set up based on seven housekeeping genes; S. aureus groups were defined by the sharing of alleles at ≥ 5 of the seven loci. In many cases, the predicted founder of a group would also be the most prevalent ST within the group. As a predicted founder of major S. aureus groups, approximately 90 % of ST121 strains was meticillin-susceptible S. aureus (MSSA). The majority of ST121 strains carry accessory gene regulator type IV, whereas staphylococcal protein A gene types for ST121 are exceptionally diverse. More than 90 % of S. aureus ST121 strains have Panton-Valentine leukocidin; other enterotoxins, haemolysins, leukocidins and exfoliative toxins also contribute to the high virulence of ST121 strains. Patients suffering from S. aureus ST121 infections often need longer hospitalization and prolonged antimicrobial therapy. In this review, we tried to summarize the epidemiology of the S. aureus clone ST121 and focused on the molecular types, toxin carriage and disease spectrum of this globally disseminated clone.
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Affiliation(s)
- Qing Rao
- Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, PR China
| | - Weilong Shang
- Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, PR China
| | - Xiaomei Hu
- Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, PR China
| | - Xiancai Rao
- Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, PR China
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47
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Rovira G, Cooke EF, Mucavele H, Sitoe A, Madrid L, Nhampossa T, Garrine M, Massora S, Cossa A, Mandomando I, Bassat Q. The Challenge of Diagnosing and Treating Staphylococcus aureus Invasive Infections in a Resource-limited Sub-Saharan Africa Setting: A Case Report. J Trop Pediatr 2015; 61:397-402. [PMID: 26187541 DOI: 10.1093/tropej/fmv045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Community-acquired methicillin-sensitive Staphylococcus aureus (CA-MSSA) is responsible for the majority of skin and soft-tissue infections. CA-MSSA can also cause life-threatening infections, possibly in relation to particular virulence factors, including Panton-Valentine leukocidin (PVL). METHODS We describe a severe CA-MSSA necrotizing pneumonia complicated with multifocal osteomyelitis, pericardial effusion and endocarditis in a 6-year-old boy admitted to a Mozambican hospital. Staphylococcus aureus isolation and antibiotic susceptibility testing were performed by conventional microbiology. Additionally, microarray assay was used for molecular characterization. RESULTS Blood culture confirmed the presence of S. aureus susceptible to most antimicrobial agents, including methicillin. Molecular characterization confirmed the presence of PVL, together with alpha and beta haemolysin genes. CONCLUSIONS To our knowledge, this is the first reported case of disseminated CA-MSSA disease with confirmed PVL exotoxin in sub-Saharan Africa. PVL-positive CA-MSSA should be considered in the differential diagnosis of community-acquired pneumonia, making laboratory testing a higher priority.
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Affiliation(s)
- Gemma Rovira
- EAP Sardenya-Hospital de la Santa Creu i Sant Pau, Barcelona, 08025, Spain
| | - Elisa F Cooke
- Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital 12 de Octubre, Madrid, 28041, Spain
| | - Helio Mucavele
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, CP1929
| | - Antonio Sitoe
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, CP1929
| | - Lola Madrid
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, CP1929 ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, 08036, Spain
| | - Tacilta Nhampossa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, CP1929 Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique, CP264
| | - Marcelino Garrine
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, CP1929
| | - Sergio Massora
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, CP1929
| | - Anelsio Cossa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, CP1929
| | - Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, CP1929 Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique, CP264
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, CP1929 ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, 08036, Spain
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48
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El-Ashker M, Gwida M, Tomaso H, Monecke S, Ehricht R, El-Gohary F, Hotzel H. Staphylococci in cattle and buffaloes with mastitis in Dakahlia Governorate, Egypt. J Dairy Sci 2015; 98:7450-9. [PMID: 26364099 DOI: 10.3168/jds.2015-9432] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 07/27/2015] [Indexed: 11/19/2022]
Abstract
The aim of this study was to provide the first detailed insight into the population structure of Staphylococcus aureus in one modern dairy farm (Gamasa) and several household cows and buffaloes in Dakahlia Governorate, Egypt. Eight hundred seventy-two quarter milk samples of 218 dairy cattle and buffaloes with clinical and subclinical mastitis were investigated. Bacteria were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and staphylococci were further characterized by DNA sequencing of 16S rRNA genes and microarray analysis. Staphylococcus aureus was present in 5.6% of all collected samples, whereas methicillin-resistant S. aureus (MRSA) represented 24.5% of all identified S. aureus (12/49). Six clonal complexes (CC) of S. aureus were detected. Staphylococcus aureus CC398 (ST291/813)-MSSA (methicillin-susceptible S. aureus) was identified frequently in the Gamasa farm in addition to a few CC5-MRSA-V isolates. However, a small number of different isolates of S. aureus were found in household cattle and buffaloes harboring different CC. The presence of these genotypes of S. aureus in milk might indicate a public health hazard, because all of these CC have previously been isolated from human patients. Thus, a recommendation was given to the owner of the dairy farm to review the hygiene regimen on the farm. In perspective, further investigation regarding S. aureus screening of all lactating cows and personnel on the farm is warranted.
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Affiliation(s)
- Maged El-Ashker
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743 Jena, Germany.
| | - Mayada Gwida
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743 Jena, Germany; Department of Hygiene and Zoonoses, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Herbert Tomaso
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743 Jena, Germany
| | - Stefan Monecke
- Institute for Medical Microbiology and Hygiene, Technische Universität Dresden, Fiedlerstr. 42, 01307 Dresden, Germany; InfectoGnostics Research Campus, 07743 Jena, Germany; Alere Technologies GmbH, Löbstedter Str. 103-105, 07749 Jena, Germany
| | - Ralf Ehricht
- InfectoGnostics Research Campus, 07743 Jena, Germany; Alere Technologies GmbH, Löbstedter Str. 103-105, 07749 Jena, Germany
| | - Fatma El-Gohary
- Department of Hygiene and Zoonoses, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Helmut Hotzel
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743 Jena, Germany
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49
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Budd KE, McCoy F, Monecke S, Cormican P, Mitchell J, Keane OM. Extensive Genomic Diversity among Bovine-Adapted Staphylococcus aureus: Evidence for a Genomic Rearrangement within CC97. PLoS One 2015; 10:e0134592. [PMID: 26317849 PMCID: PMC4552844 DOI: 10.1371/journal.pone.0134592] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 07/11/2015] [Indexed: 01/22/2023] Open
Abstract
Staphylococcus aureus is an important pathogen associated with both human and veterinary disease and is a common cause of bovine mastitis. Genomic heterogeneity exists between S. aureus strains and has been implicated in the adaptation of specific strains to colonise particular mammalian hosts. Knowledge of the factors required for host specificity and virulence is important for understanding the pathogenesis and management of S. aureus mastitis. In this study, a panel of mastitis-associated S. aureus isolates (n = 126) was tested for resistance to antibiotics commonly used to treat mastitis. Over half of the isolates (52%) demonstrated resistance to penicillin and ampicillin but all were susceptible to the other antibiotics tested. S. aureus isolates were further examined for their clonal diversity by Multi-Locus Sequence Typing (MLST). In total, 18 different sequence types (STs) were identified and eBURST analysis demonstrated that the majority of isolates grouped into clonal complexes CC97, CC151 or sequence type (ST) 136. Analysis of the role of recombination events in determining S. aureus population structure determined that ST diversification through nucleotide substitutions were more likely to be due to recombination compared to point mutation, with regions of the genome possibly acting as recombination hotspots. DNA microarray analysis revealed a large number of differences amongst S. aureus STs in their variable genome content, including genes associated with capsule and biofilm formation and adhesion factors. Finally, evidence for a genomic arrangement was observed within isolates from CC97 with the ST71-like subgroup showing evidence of an IS431 insertion element having replaced approximately 30 kb of DNA including the ica operon and histidine biosynthesis genes, resulting in histidine auxotrophy. This genomic rearrangement may be responsible for the diversification of ST71 into an emerging bovine adapted subgroup.
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Affiliation(s)
- Kathleen E. Budd
- Animal & Bioscience Department, AGRIC, Teagasc, Grange, Dunsany, Co. Meath, Ireland
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Finola McCoy
- Animal Health Ireland, Carrick-on-Shannon, Co. Leitrim, Ireland
| | - Stefan Monecke
- Alere Technologies GmbH, Löbstedter Straße 103–105, D-07749 Jena, Germany
| | - Paul Cormican
- Animal & Bioscience Department, AGRIC, Teagasc, Grange, Dunsany, Co. Meath, Ireland
| | - Jennifer Mitchell
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Orla M. Keane
- Animal & Bioscience Department, AGRIC, Teagasc, Grange, Dunsany, Co. Meath, Ireland
- * E-mail:
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50
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Conceição T, Coelho C, de Lencastre H, Aires-de-Sousa M. Frequent occurrence of oxacillin-susceptiblemecA-positiveStaphylococcus aureus(OS-MRSA) strains in two African countries: Table 1. J Antimicrob Chemother 2015; 70:3200-4. [DOI: 10.1093/jac/dkv261] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 07/29/2015] [Indexed: 12/22/2022] Open
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