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Donkor ES, Odoom A, Osman AH, Darkwah S, Kotey FCN. A Systematic Review on Antimicrobial Resistance in Ghana from a One Health Perspective. Antibiotics (Basel) 2024; 13:662. [PMID: 39061344 PMCID: PMC11274323 DOI: 10.3390/antibiotics13070662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) poses a global health threat, with lower-middle-income countries bearing a disproportionate burden. Surveillance of AMR under a One Health framework is needed to elucidate the associations among clinical, animal, and environmental AMR. This review aimed to describe the state of AMR in Ghana, focusing on One Health. METHOD This review utilized the PRISMA guidelines and major databases to systematically search and analyze AMR in Ghana published from 1 January 2014 to 1 May 2023. RESULTS Out of the 48 articles that met the inclusion criteria, 28 studies were conducted on humans, 14 studies involved animals, and 6 studies focused on the environment. A total of 48 different pathogens were identified across the human, animal, and environmental sectors, with the most common being Escherichia coli (67%, n = 32), Klebsiella spp. (52%, n = 25), Pseudomonas spp. (40%, n = 19), and Salmonella spp. (38%, n = 18). Generally, a high prevalence of antibiotic resistance was observed among various bacterial species across the sectors. These bacteria exhibited resistance to commonly used antibiotics, with resistance to ampicillin and tetracycline exceeding 80%, and multidrug resistance (MDR) ranging from 17.6% in Shigella spp. to 100% in Acinetobacter spp. CONCLUSION This review reaffirms the significant challenge of AMR in Ghana, with a high prevalence observed in the human, animal, and environmental sectors. Key pathogens (e.g., Staphylococcus aureus and Escherichia coli) found across the sectors emphasize the urgent need for a One Health approach to tackle AMR in Ghana.
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Affiliation(s)
- Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana; (A.O.); (A.-H.O.); (S.D.); (F.C.N.K.)
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Tagoe JNA, Yeboah C, Behene E, Kumordjie S, Nimo-Paintsil S, Attram N, Nyarko EO, Carroll JA, Fox AT, Watters C, Koram K, Anang AK, Sanders T, Letizia AG. Coinfection of Malaria and Bacterial Pathogens among Acute Febrile Patients in Selected Clinics in Ghana. Am J Trop Med Hyg 2023; 109:1036-1046. [PMID: 37748764 PMCID: PMC10622490 DOI: 10.4269/ajtmh.23-0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/05/2023] [Indexed: 09/27/2023] Open
Abstract
Malaria remains the leading cause of acute febrile illness (AFI) in Africa despite successful control measures and programs. Acute febrile illnesses can be misdiagnosed as malaria as a result of the overlapping spectrum of nonspecific symptoms or may not be pursued because of limited diagnostic capabilities. This study investigated potential etiologies of AFIs in Ghana and determined the relationship between coinfection between malaria and Q fever, leptospirosis, and culturable bacteria in febrile patients. Participants were enrolled between July 2015 and December 2019 from four Ghanaian military treatment facilities. Of the 399 febrile participants, 222 (55.6%) males and 177 (44.6%) females were enrolled. Malaria was diagnosed in 275 (68.9%) participants. Malaria coinfection occurred with leptospirosis, Q fever, and blood-cultured bacteria in 11/206 (5.3%), 24/206 (11.7%), and 6/164 (3.7%) participants, respectively. Among the 124 malaria-negative samples, the positivity rates were 4.1% (3/74), 8.1% (6/74), and 3.6% (2/56) for leptospirosis, Q fever, and bacterial pathogens isolated from blood culture, respectively. The majority of documented clinical signs and symptoms were not significantly associated with specific diseases. Approximately 10% of malaria-positive participants also had evidence suggesting the presence of a bacterial coinfection. Therefore, even in the case of a positive malaria test, other pathogens contributing to febrile illness should be considered. Understanding the frequency of malaria coinfection and other etiological agents responsible for AFIs will improve diagnosis and treatment and better inform public health knowledge gaps in Ghana.
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Affiliation(s)
- Janice N. A. Tagoe
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | - Clara Yeboah
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | - Eric Behene
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | - Selassie Kumordjie
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | | | - Naiki Attram
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | | | | | - Anne T. Fox
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | - Chaselynn Watters
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | - Kwadwo Koram
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | | | - Terrel Sanders
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
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Garrine M, Costa SS, Messa A, Massora S, Vubil D, Ácacio S, Nhampossa T, Bassat Q, Mandomando I, Couto I. Antimicrobial resistance and clonality of Staphylococcus aureus causing bacteraemia in children admitted to the Manhiça District Hospital, Mozambique, over two decades. Front Microbiol 2023; 14:1208131. [PMID: 37555065 PMCID: PMC10406509 DOI: 10.3389/fmicb.2023.1208131] [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: 04/18/2023] [Accepted: 07/04/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Staphylococcus aureus is one of the main causes of bacteraemia, associated with high mortality, mainly due to the occurrence of multidrug resistant (MDR) strains. Data on antibiotic susceptibility and genetic lineages of bacteraemic S. aureus are still scarce in Mozambique. The study aims to describe the antibiotic susceptibility and clonality of S. aureus isolated from blood cultures of children admitted to the Manhiça District Hospital over two decades (2001-2019). METHODS A total of 336 S. aureus isolates detected in blood cultures of children aged <5 years were analyzed for antibiotic susceptibility by disk diffusion or minimal inhibitory concentration, and for the presence of resistance determinants by PCR. The clonality was evaluated by SmaI-PFGE, spa typing, and MLST. The SCCmec element was characterized by SCCmec typing. RESULTS Most S. aureus (94%, 317/336) were resistant to at least one class of antibiotics, and one quarter (25%) showed a MDR phenotype. High rates of resistance were detected to penicillin (90%) and tetracycline (48%); followed by erythromycin/clindamycin (25%/23%), and co-trimoxazole (11%), while resistance to methicillin (MRSA strains) or gentamicin was less frequent (≤5%). The phenotypic resistance to distinct antibiotics correlated well with the corresponding resistance determinants (Cohen's κ test: 0.7-1.0). Molecular typing revealed highly diverse clones with predominance of CC5 (17%, 58/336) and CC8 (16%), followed by CC15 (11%) and CC1 (11%). The CC152, initially detected in 2001, re-emerged in 2010 and became predominant throughout the remaining surveillance period, while other CCs (CC1, CC5, CC8, CC15, CC25, CC80, and CC88) decreased over time. The 16 MRSA strains detected belonged to clones t064-ST612/CC8-SCCmecIVd (69%, 11/16), t008-ST8/CC8-SCCmecNT (25%, 4/16) and t5351-ST88/CC88-SCCmecIVa (6%, 1/16). Specific clonal lineages were associated with extended length of stay and high in-hospital mortality. CONCLUSION We document the circulation of diverse MDR S. aureus causing paediatric bacteraemia in Manhiça district, Mozambique, requiring a prompt recognition of S. aureus bacteraemia by drug resistant clones to allow more targeted clinical management of patients.
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Affiliation(s)
- Marcelino Garrine
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisbon, Portugal
| | - Sofia Santos Costa
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisbon, Portugal
| | - Augusto Messa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Sérgio Massora
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Delfino Vubil
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Sozinho Ácacio
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique
| | - Tacilta Nhampossa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- ICREA, Barcelona, Spain
- Department of Pediatrics, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Isabel Couto
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisbon, Portugal
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Qasim Hameed H, Ahmed Saeed I, Abdalhadi Hussain E. Detection of lukf-pv gene in Staphylococcus aureus isolated from pregnant women with Urinary tract infection. BIONATURA 2023. [DOI: 10.21931/rb/2023.08.01.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Staphylococcus aureus is a human pathogen as well as commensal bacteria. S. aureus has colonized around 30% of the human population. This study aimed to diagnose Staphylococcus aureus by molecular techniques, correlate the resistance against selected antimicrobial substances with the presence of the lukf-pv gene, and find the sequence of lukf-pv gene for the isolates obtained to investigate the mutations of those obtained isolates. This study included 60 patients diagnosed by the hospital with a urinary tract infection in Teaching Medical City Hospital, Baghdad, and Al-Yarmouk Teaching Hospital, between January 2021 and July 2021. The isolates were cultured on a blood agar overnight; then, isolates were diagnosed by VITEK as S. aureus. DNA has been isolated from all the included samples. A specific region of the 16SRNA gene has been amplified to diagnose S. aureus by molecular techniques. Then possession of the lukf-pv gene was tested by PCR, then amplified products were sequenced to detect the mutations within the lukf-pv gene. The finding appeared that blood group O+ has the highest rate of bacterial infection, the lowest is O- (1.7%), and the highest rate is shown within people not suffering from complicated diseases (65%). Of the 60 isolates, 60 (100%) were confirmed by 16sRNA gene amplification and were positive, among which 37 (61.6%) were lukf-pv positive. Results of the lukf-pv gene sequences showed around 501 bits score and 96% compatibility (ID: CP076105.1). The current study showed that antibiotics Cefoxitin, Benzylpenicillin, Oxacillin, Clindamycin, Fusidic acid, Rifampicin, Erythromycin, Vancomycin, and Teicoplanin had the highest resistance to antibiotics and as follow;100 %, 100 %, 40.54 %, 27.03 %, 27.03 %, 16.22 %, 13.51 %, and 10.81 %, respectively.
Keywords: Staphylococcus aureus, 16sRNA and lukf-pv genes
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Affiliation(s)
- Hiba Qasim Hameed
- Department of Biology, College of Education for pure science Ibn-Al Haitham, University of Baghdad, Baghdad, Iraq
| | - Inas Ahmed Saeed
- Department of Microbiology ,Collage of Medicine, University of Babylon
| | - Enas Abdalhadi Hussain
- Department of Biology, College of Education for pure science Ibn-Al Haitham, University of Baghdad, Baghdad, Iraq
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Appiah B, Asamoah-Akuoko L, Samman E, Koduah A, Kretchy IA, Ludu JY, Odonkor G, Nam SH, Gyansa-Luterrodt M. The impact of antimicrobial resistance awareness interventions involving schoolchildren, development of an animation and parents engagements: a pilot study. Antimicrob Resist Infect Control 2022; 11:26. [PMID: 35120562 PMCID: PMC8817549 DOI: 10.1186/s13756-022-01062-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 01/13/2022] [Indexed: 08/20/2023] Open
Abstract
Background Antimicrobial resistance (AMR) is a global health challenge, particularly in low- and middle-income countries where antibiotics are widely available to consumers, leading to their misuse. However, AMR educational interventions for engaging parents of schoolchildren are mainly lacking in Sub-Saharan Africa. This study aimed to assess the potential of AMR animation and schoolchildren in influencing parents’ AMR knowledge, attitudes, and beliefs.
Methods Parents of schoolchildren aged 11–15 years in Tema, a city in Ghana, watched and discussed an AMR animation designed with ideas from the schoolchildren’s top stories and picture drawings. The children from two schools were first engaged with AMR lessons, with one school using storytelling, the other school using picture drawing, and none serving as a control. The children were then asked to discuss the lessons with their parents. Baseline surveys of parents of randomly selected children were conducted to assess AMR knowledge, attitudes and beliefs before engaging the students and parents, and immediately after the parents participated in viewing and discussing the animation. McNemar and t-tests were used to assess changes in AMR knowledge, attitudes and beliefs.
Results Parents who participated in the animation event, and whose schoolchildren were in the storytelling intervention school had significantly improved knowledge regarding the statement “Antibiotics will cure any infection” (p = 0.021, χ2 = 0.711; 88% vs 50%) between baseline and endline. However, these parents also had statistically significant decreased scores regarding the statement “Antibiotics do not kill our good bacteria” (p = 0.021, χ2 = 1.042; 71.4% vs 40%) between baseline and endline. There was no significant effect on any statement among parents whose children were in the picture drawing school. However, t-test results combining the statements as composite scores showed statistically significant difference in only the attitude construct among parents whose children participated in storytelling intervention (p = 0.043) or picture drawing intervention (p = 0.019). There were no statistically significant changes in knowledge and beliefs constructs.
Conclusions This study shows that interventions involving schoolchildren with parents engagements and AMR animation could influence parents’ AMR attitudes. The intervention could also positively or negatively impact parents’ AMR knowledge. Modifications of the interventions may be needed for tackling AMR. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01062-6.
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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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SARS-CoV-2 with Panton-Valentine leukocidin-producing Staphylococcus aureus healthcare-associated pneumonia in the Indian Ocean. Heliyon 2022; 8:e10422. [PMID: 36091947 PMCID: PMC9444300 DOI: 10.1016/j.heliyon.2022.e10422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 07/04/2022] [Accepted: 08/18/2022] [Indexed: 11/21/2022] Open
Abstract
At this time, the literature reports only one case of superinfection with Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus in a patient with severe acute respiratory distress syndrome secondary to coronavirus 2 (SARS-CoV-2) pneumonia. Here we report the first two cases of PVL-producing S. aureus healthcare-associated pneumonia in patients hospitalized for SARS-CoV-2 pneumonia in the Indian Ocean region. The two isolated strains of S. aureus were found to belong to the ST152/t355 clone, a known PVL-producing S. aureus clone that circulates in Africa and is responsible for infections imported into Europe. Our two cases reinforce the hypothesis that SARS-CoV-2 infection favors the occurrence of PVL-producing S. aureus pneumonia. Production of PVL should be searched in patients returning from the Indian Ocean region who present with severe SARS-CoV-2 pneumonia complicated by superinfection with S. aureus even in the case of late onset healthcare-associated pneumonia
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Lawal OU, Ayobami O, Abouelfetouh A, Mourabit N, Kaba M, Egyir B, Abdulgader SM, Shittu AO. A 6-Year Update on the Diversity of Methicillin-Resistant Staphylococcus aureus Clones in Africa: A Systematic Review. Front Microbiol 2022; 13:860436. [PMID: 35591993 PMCID: PMC9113548 DOI: 10.3389/fmicb.2022.860436] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of hospital-associated (HA) and community-associated (CA) infections globally. The multi-drug resistant nature of this pathogen and its capacity to cause outbreaks in hospital and community settings highlight the need for effective interventions, including its surveillance for prevention and control. This study provides an update on the clonal distribution of MRSA in Africa. Methods A systematic review was conducted by screening for eligible English, French, and Arabic articles from November 2014 to December 2020, using six electronic databases (PubMed, EBSCOhost, Web of Science, Scopus, African Journals Online, and Google Scholar). Data were retrieved and analyzed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (registered at PROSPERO: CRD42021277238). Genotyping data was based primarily on multilocus sequence types (STs) and Staphylococcal Cassette Chromosome mec (SCCmec) types. We utilized the Phyloviz algorithm in the cluster analysis and categorization of the MRSA STs into various clonal complexes (CCs). Results We identified 65 studies and 26 publications from 16 of 54 (30%) African countries that provided sufficient genotyping data. MRSA with diverse staphylococcal protein A (spa) and SCCmec types in CC5 and CC8 were reported across the continent. The ST5-IV [2B] and ST8-IV [2B] were dominant clones in Angola and the Democratic Republic of Congo (DRC), respectively. Also, ST88-IV [2B] was widely distributed across the continent, particularly in three Portuguese-speaking countries (Angola, Cape Verde, and São Tomé and Príncipe). The ST80-IV [2B] was described in Algeria and Egypt, while the HA-ST239/ST241-III [3A] was only identified in Egypt, Ghana, Kenya, and South Africa. ST152-MRSA was documented in the DRC, Kenya, Nigeria, and South Africa. Panton-Valentine leukocidin (PVL)-positive MRSA was observed in several CCs across the continent. The median prevalence of PVL-positive MRSA was 33% (ranged from 0 to 77%; n = 15). Conclusion We observed an increase in the distribution of ST1, ST22, and ST152, but a decline of ST239/241 in Africa. Data on MRSA clones in Africa is still limited. There is a need to strengthen genomic surveillance capacity based on a "One-Health" strategy to prevent and control MRSA in Africa.
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Affiliation(s)
- Opeyemi Uwangbaoje Lawal
- Laboratory of Bacterial Evolution and Molecular Epidemiology, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa (ITQB-NOVA), Oeiras, Portugal
| | - Olaniyi Ayobami
- Unit for Healthcare-Associated Infections, Surveillance of Antimicrobial Resistance and Consumption, Robert Koch Institute, Berlin, Germany
| | - Alaa Abouelfetouh
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.,Department of Microbiology and Immunology, Faculty of Pharmacy, AlAlamein International University, Alalamein, Egypt
| | - Nadira Mourabit
- Biotechnology, Environmental Technology and Valorisation of Bio-Resources Team, Department of Biology, Faculty of Sciences and Techniques of Al Hoceima, Abdelmalek Essaadi University, Tetouan, Morocco
| | - Mamadou Kaba
- Division of Medical Microbiology, Department of Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Shima M Abdulgader
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - Adebayo Osagie Shittu
- Department of Microbiology, Obafemi Awolowo University, Ile-Ife, Nigeria.,Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
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Pany S, Sharma BM, Sen SK, Pal BB. Association of PVL Gene in MSSA and MRSA Strains among Diabetic Ulcer Patients from Odisha, India. INT J LOW EXTR WOUND 2022:15347346221091355. [PMID: 35379025 DOI: 10.1177/15347346221091355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Staphylococcus aureus has emerged as an important pathogen among diabetic foot ulcers in patients with diabetes. Infections with S. aureus in diabetic ulcers need surveillance of resistant microbial profile to provide the basis for empirical therapy for the reduction of lower extremities amputation. Panton valentine leucocidin (PVL) is considered as one of the major virulence gene of S. aureus which is responsible for destruction of white blood cells and tissue necrosis. This pore forming cytotoxin gene is carried out by both methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) strains. The present study described the prevalence of PVL gene in MSSA and MRSA strains isolated from diabetic ulcer patients treated during November, 2019 to January, 2021 from a tertiary care hospital, Odisha. Infected tissue and blood samples from these patients were collected aseptically and sub-cultured using different media and standard techniques. The isolated genomic DNA of MSSA and MRSA strains were subjected to PCR assay for the detection of PVL gene. Two hundred ten S. aureus out of 402 diabetic ulcer patients were isolated having 59.52% MSSA and 40.47% MRSA strains. Wagner's grade III and grade IV ulcers were most prevalent in these ulcer patients. The prevalence of PVL gene in MSSA strains was more in comparison to MRSA strains. Forty five resistance patterns were observed from the antibiogram profiles of S. aureus. The present study highlighted that PVL gene could not be a marker for the detection of MRSA and MSSA strains in diabetic ulcer patients.
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Affiliation(s)
- Swatishree Pany
- Microbiology Division, 29727ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Bayasis M Sharma
- Microbiology Division, 29727ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Shibani K Sen
- Kanungo Diabetes and Multispecialty Hospital, Bhubaneswar, Odisha, India
| | - Bibhuti B Pal
- Microbiology Division, 29727ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Paintsil EK, Ofori LA, Adobea S, Akenten CW, Phillips RO, Maiga-Ascofare O, Lamshöft M, May J, Obiri Danso K, Krumkamp R, Dekker D. Prevalence and Antibiotic Resistance in Campylobacter spp. Isolated from Humans and Food-Producing Animals in West Africa: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:140. [PMID: 35215086 PMCID: PMC8877155 DOI: 10.3390/pathogens11020140] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 12/30/2022] Open
Abstract
Campylobacter species are one of the leading causes of gastroenteritis in humans. This review reports on the prevalence and antibiotic resistance data of Campylobacter spp. isolated from humans and food-producing animals in West Africa. A systematic search was carried out in five databases for original articles published between January 2000 and July 2021. Among 791 studies found, 38 original articles from seven (41%) out of the 17 countries in West Africa met the inclusion criteria. For studies conducted in food-producing animals, the overall pooled prevalence of Campylobacter spp. was 34% (95% CI: 25-45). The MDR prevalence was 59% (95% CI: 29-84) and half (50%, 13/26) of the animal studies had samples collected from the market. The human studies recorded a lower pooled prevalence of Campylobacter spp. (10%, 95% CI: 6-17), but a considerably higher rate of MDR prevalence (91%; 95% CI: 67-98). The majority (85%, 11/13) of the human studies took place in a hospital. Campylobacter jejuni and Campylobacter coli were the most common species isolated from both animals and humans. Our findings suggest that Campylobacter spp. is highly prevalent in West Africa. Therefore, improved farm hygiene and 'One Health' surveillance systems are needed to reduce transmission.
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Affiliation(s)
- Ellis Kobina Paintsil
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), South-End, Asuogya Road, Kumasi 039-5028, Ghana; (C.W.A.); (R.O.P.); (O.M.-A.)
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi 039-5028, Ghana; (L.A.O.); (K.O.D.)
| | - Linda Aurelia Ofori
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi 039-5028, Ghana; (L.A.O.); (K.O.D.)
| | - Sarah Adobea
- Department of Emergency Medicine, Komfo Anokye Teaching Hospital, Okomfo Anokye Road, Kumasi 034-9094, Ghana;
| | - Charity Wiafe Akenten
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), South-End, Asuogya Road, Kumasi 039-5028, Ghana; (C.W.A.); (R.O.P.); (O.M.-A.)
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi 039-5028, Ghana; (L.A.O.); (K.O.D.)
| | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), South-End, Asuogya Road, Kumasi 039-5028, Ghana; (C.W.A.); (R.O.P.); (O.M.-A.)
| | - Oumou Maiga-Ascofare
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), South-End, Asuogya Road, Kumasi 039-5028, Ghana; (C.W.A.); (R.O.P.); (O.M.-A.)
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, 20359 Hamburg, Germany; (M.L.); (J.M.); (D.D.)
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, 20359 Hamburg, Germany
| | - Maike Lamshöft
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, 20359 Hamburg, Germany; (M.L.); (J.M.); (D.D.)
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, 20359 Hamburg, Germany
| | - Jürgen May
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, 20359 Hamburg, Germany; (M.L.); (J.M.); (D.D.)
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, 20359 Hamburg, Germany
- Tropical Medicine II, University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Kwasi Obiri Danso
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi 039-5028, Ghana; (L.A.O.); (K.O.D.)
| | - Ralf Krumkamp
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, 20359 Hamburg, Germany; (M.L.); (J.M.); (D.D.)
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, 20359 Hamburg, Germany
| | - Denise Dekker
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, 20359 Hamburg, Germany; (M.L.); (J.M.); (D.D.)
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, 20359 Hamburg, Germany
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Investigation of Virulence Genes of Staphylococcus aureus Isolated from Sterile Body Fluid Samples and Their Correlation with Clinical Symptoms and Outcomes. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2022; 2021:5354747. [PMID: 34987680 PMCID: PMC8720599 DOI: 10.1155/2021/5354747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/15/2021] [Indexed: 12/31/2022]
Abstract
Staphylococcus aureus is the major pathogen causing nosocomial human infections and produces a variety of virulence factors that contribute to its ability to colonize and cause diseases. This study was conducted to investigate the virulence genes in S. aureus isolated from sterile body fluid samples and their correlation with clinical symptoms and outcomes. The VITEK 2® Compact system was used to perform biochemical identification and antimicrobial susceptibility tests on 33 S. aureus isolates. Virulence genes were amplified using multiplex PCR. The virulence gene patterns were analyzed by systematic cluster analysis. The frequency of methicillin-resistant S. aureus was 45.45%, and 17 virulence genes were identified. Genes encoding hemolysins showed high frequencies. The frequencies of hla, hlb, hld, and hlgB were 93.94% and that of the luk-F/S-PV was 21.21%. Except for the frequency of splB (51.52%), the remaining genes encoding invasive proteases showed frequencies greater than 81.82%. Among the patients, 100.00% had undergone invasive medical procedures and 24.00% had been treated with more than three types of antibiotic drugs. Invasive medical procedures are the main causes of infection. Resistance to antibiotic drugs and the status of carrying virulence genes were highly related to clinical symptoms and outcomes.
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Antimicrobial Usage in Commercial and Domestic Poultry Farming in Two Communities in the Ashanti Region of Ghana. Antibiotics (Basel) 2021; 10:antibiotics10070800. [PMID: 34209451 PMCID: PMC8300702 DOI: 10.3390/antibiotics10070800] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022] Open
Abstract
Poultry farming is a common practice in Ghana. Antibiotics are used, particularly in commercial poultry farming, as growth promoters and to prevent and cure infections. However, there is little information on antimicrobial usage in domestic poultry farming in Ghana. This study aimed to describe antimicrobial usage in commercial and domestic poultry farming. A cross-sectional survey was conducted within the Ashanti region of Ghana including 33 commercial farms and 130 households with domestic poultry farming. The median poultry population on commercial farms was 1500 (IQR: 300–3000) compared with 18 (IQR: 10–25) on domestic farms. The majority (97%, n = 32) of commercial farms used antimicrobials, compared with 43% (n = 56) of the domestic farms. Commercial farmers were 6.1 (CI: 3.2–11.8) times more likely to read and follow instructions on antimicrobials in comparison with domestic poultry keepers. About 11% of domestic and 34% of commercial farmers had received education on antimicrobial usage. None of the commercial farmers used herbal remedies; however, 40% (n/N = 52/130) of domestic farmers administered herbs. The misuse of antimicrobials in domestic poultry production calls for stricter regulations and training to limit the emergence and spread of antimicrobial-resistant bacteria among poultry.
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13
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Resistance Status of Bacteria from a Health Facility in Ghana: A Retrospective Study. J Pathog 2021; 2021:6648247. [PMID: 33747569 PMCID: PMC7952191 DOI: 10.1155/2021/6648247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background Regardless of the global concerted effort to control the development and spread of antimicrobial resistance, increasing cases are continually documented at many medical centres. This situation is reinforced by inadequate information on the trend of resistance resulting from lack of regular antimicrobial resistance surveillance. The present study sought to detect the number of multidrug-resistant (MDR), extended drug-resistant (XDR), and pandrug-resistant (PDR) bacterial isolates at a health facility in Ghana from January 2018 to July 2020. Method A total of 800 data on antimicrobial testing results were extracted from the records of the health facility. The extracted data were explored for the detection of MDR, XDR, and PDR. The study further determined the use of antibiotics using the multiple-drug resistance index (MDRI). Results Except for Staphylococcus and Neisseria spp., all bacterial isolates showed extremely high (100%) proportion of MDR. Although only Staphylococcus spp. (38 (4.8%)) was observed to be XDR, the rest of the bacteria showed the potential to attain the status of XDR or PDR. MDRI indicated high use of antibiotics in the health facility. Conclusion The high antimicrobial resistance observed by the study underscores the need for prompt and effective antibiotic resistance control strategies.
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14
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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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15
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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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16
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Kwapisz E, Garbacz K, Kosecka-Strojek M, Schubert J, Bania J, Międzobrodzki J. Presence of egc-positive major clones ST 45, 30 and 22 among methicillin-resistant and methicillin-susceptible oral Staphylococcus aureus strains. Sci Rep 2020; 10:18889. [PMID: 33144661 PMCID: PMC7609576 DOI: 10.1038/s41598-020-76009-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/22/2020] [Indexed: 02/06/2023] Open
Abstract
The oral cavity may comprise a significant reservoir for Staphylococcus aureus but the data on molecular epidemiology and clonal distribution of oral strains are really scarce. This study aimed to evaluate the clonal relatedness in S. aureus isolated from oral cavity and their relationship with carriage of virulence genes, and antimicrobial resistance profiles. A total of 139 oral S. aureus isolates were obtained from 2327 analysed oral samples of dental patients. Antimicrobial susceptibility testing was performed. Isolates were characterized using protein A gene (spa) typing, spa-CC clonal complexes, toxin genes and SCCmec typing for MRSA. High resistance rates for penicillin, tetracycline and gentamicin were detected, respectively 58.3%, 42.4%, and 35.2%. Twelve (8.6%) S. aureus isolates were identified as MRSA. All of MRSA isolates were mecA-positive and mecC-negative. SCCmec IV was the most common type (66.7%), which was typical for community-acquired MRSA (CA-MRSA). Overall, the enterotoxin gene cluster (egc) was the most frequent detected virulence factor (44.9%), both in MSSA and MRSA isolates. Presence of genes encoding for the enterotoxins (sea, seb, sec, seh, sek), exfoliative toxin A (eta), and toxic shock syndrome toxin-1 (tst) was also observed. Strains carrying lukS-PV/lukF-PV genes belonged to SCCmecV- spa type t437. The most prevalent spa types were t091, t015, t084, t002, t571, and t026 among all 57 identified. Spa types, including 3 new ones, grouped in 6 different spa-CC clonal complexes, with four major dominated; CC45, CC30, CC5, and CC15. This study demonstrated that both methicillin-susceptible and methicillin-resistant major European clones of S. aureus could be isolated from the oral cavity of dental patients, with the emergence of PVL-positive CA-MRSA strains. The oral cavity should be considered as a possible source of toxigenic egc-positive S. aureus strains, in terms of potential risk of cross-infection and dissemination to other body sites.
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Affiliation(s)
- Ewa Kwapisz
- Department of Oral Microbiology, Medical Faculty, Medical University of Gdansk, Gdansk, Poland
| | - Katarzyna Garbacz
- Department of Oral Microbiology, Medical Faculty, Medical University of Gdansk, Gdansk, Poland.
| | - Maja Kosecka-Strojek
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Justyna Schubert
- Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Jacek Bania
- Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Jacek Międzobrodzki
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
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17
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Human mecC-Carrying MRSA: Clinical Implications and Risk Factors. Microorganisms 2020; 8:microorganisms8101615. [PMID: 33092294 PMCID: PMC7589452 DOI: 10.3390/microorganisms8101615] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022] Open
Abstract
A new methicillin resistance gene, named mecC, was first described in 2011 in both humans and animals. Since then, this gene has been detected in different production and free-living animals and as an agent causing infections in some humans. The possible impact that these isolates can have in clinical settings remains unknown. The current available information about mecC-carrying methicillin resistant S. aureus (MRSA) isolates obtained from human samples was analyzed in order to establish its possible clinical implications as well as to determine the infection types associated with this resistance mechanism, the characteristics of these mecC-carrying isolates, their possible relation with animals and the presence of other risk factors. Until now, most human mecC-MRSA infections have been reported in Europe and mecC-MRSA isolates have been identified belonging to a small number of clonal complexes. Although the prevalence of mecC-MRSA human infections is very low and isolates usually contain few resistance (except for beta-lactams) and virulence genes, first isolates harboring important virulence genes or that are resistant to non-beta lactams have already been described. Moreover, severe and even fatal human infection cases have been detected. mecC-carrying MRSA should be taken into consideration in hospital, veterinary and food safety laboratories and in prevention strategies in order to avoid possible emerging health problems.
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18
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Appiah VA, Pesewu GA, Kotey FCN, Boakye AN, Duodu S, Tette EMA, Nyarko MY, Donkor ES. Staphylococcus aureus Nasal Colonization among Children with Sickle Cell Disease at the Children's Hospital, Accra: Prevalence, Risk Factors, and Antibiotic Resistance. Pathogens 2020; 9:pathogens9050329. [PMID: 32354004 PMCID: PMC7280972 DOI: 10.3390/pathogens9050329] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to investigate S. aureus carriage among children with sickle cell disease (SCD), including the prevalence, risk factors, and antibiotic resistance. The study was cross-sectional, and involved 120 children with SCD recruited at the Princess Marie Louise Children’s Hospital (PML) in Accra and 100 apparently healthy children from environs of the hospital. Nasal swab samples were collected from the study participants and cultured for bacteria. Confirmation of S. aureus and methicillin-resistant Staphylococcus aureus (MRSA) isolates were done using the tube coagulase test and mecA polymerase chain reaction, respectively. All the S. aureus isolates were tested against standard antimicrobial agents using the Kirby-Bauer method. A structured questionnaire was used to obtain the socio-demographic and clinical data of the study participants. Binary logistic regression was used to identify determinants of S. aureus and MRSA carriage among the study participants. The nasal carriage prevalence of S. aureus was 33.3% (n = 40) and 10% (n = 10) among the participants of the SCD and control groups, respectively. As regards MRSA nasal carriage prevalence, the respective values were 3.33% (n = 4) and 0.00% (n = 0). SCD was significantly associated with S. aureus colonization (p < 0.0001, OR = 4.045), but not MRSA colonization (p = 0.128). In the SCD group, the significant predictors of S. aureus carriage were increasing age (p = 0.003; OR = 1.275) and living in self-contained apartments (p = 0.033; OR = 3.632), whereas male gender (p = 0.018; OR = 0.344) and the practice of self-medication (p = 0.039; OR = 0.233) were protective of S. aureus carriage. In the control group, a history of hospitalization in the past year was a risk factor for the carriage of S. aureus (p = 0.048; OR = 14.333). Among the participants of the SCD and control groups, respectively, the resistance prevalence recorded by S. aureus against the various antibiotics investigated were penicillin (100% each), cotrimoxazole (27.5% vs. 20%), tetracycline (25% vs. 50%), rifampicin (82.5% vs. 50%), erythromycin (30% vs. 20%), clindamycin (32.5% vs. 50%), gentamicin (7.5% vs. 20%), cefoxitin (27.5% vs. 20%), linezolid (30% vs. 40%), and fusidic acid (95% vs. 80%). The proportion of S. aureus isolates that were multidrug resistant (MDR) was 92.5% (37/40) in the SCD group and 100% (10/10) in the control group.
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Affiliation(s)
- Vera A. Appiah
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
| | - George A. Pesewu
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
| | - Fleischer C. N. Kotey
- FleRhoLife Research Consult, Teshie P. O. Box TS 853, Accra, Ghana
- Department of Medical Microbiology, University of Ghana Medical School, Accra P. O. Box 4236, Ghana
| | - Alahaman Nana Boakye
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
- FleRhoLife Research Consult, Teshie P. O. Box TS 853, Accra, Ghana
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
| | - Edem M. A. Tette
- Department of Community Health, University of Ghana Medical School, Accra P. O. Box 4236, Ghana
| | - Mame Y. Nyarko
- Princess Marie Louise Children’s Hospital, Accra P. O. Box GP 122, Ghana
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P. O. Box 4236, Ghana
- Correspondence: or ; Tel.: +233-553-527-140
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Dweba CC, Zishiri OT, El Zowalaty ME. Isolation and Molecular Identification of Virulence, Antimicrobial and Heavy Metal Resistance Genes in Livestock-Associated Methicillin-Resistant Staphylococcus aureus. Pathogens 2019; 8:pathogens8020079. [PMID: 31207959 PMCID: PMC6630769 DOI: 10.3390/pathogens8020079] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/16/2019] [Accepted: 05/16/2019] [Indexed: 02/07/2023] Open
Abstract
Staphylococcus aureus is one of the most important pathogens of humans and animals. Livestock production contributes a significant proportion to the South African Gross Domestic Product. Consequently, the aim of this study was to determine for the first time the prevalence, virulence, antibiotic and heavy metal resistance in livestock-associated S. aureus isolated from South African livestock production systems. Microbial phenotypic methods were used to detect the presence of antibiotic and heavy metal resistance. Furthermore, molecular DNA based methods were used to genetically determine virulence as well as antibiotic and heavy metal resistance determinants. Polymerase chain reaction (PCR) confirmed 217 out of 403 (53.8%) isolates to be S. aureus. Kirby-Bauer disc diffusion method was conducted to evaluate antibiotic resistance and 90.8% of S. aureus isolates were found to be resistant to at least three antibiotics, and therefore, classified as multidrug resistant. Of the antibiotics tested, 98% of the isolates demonstrated resistance towards penicillin G. High resistance was shown against different heavy metals, with 90% (196/217), 88% (192/217), 86% (188/217) and 84% (183/217) of the isolates resistant to 1500 µg/mL concentration of Cadmium (Cd), Zinc (Zn), Lead (Pb) and Copper (Cu) respectively. A total of 10 antimicrobial resistance and virulence genetic determinants were screened for all livestock associated S. aureus isolates. Methicillin-resistant S. aureus (MRSA) isolates were identified, by the presence of mecC, in 27% of the isolates with a significant relationship (p < 0.001)) with the host animal. This is the first report of mecC positive LA-MRSA in South Africa and the African continent. The gene for tetracycline resistance (tetK) was the most frequently detected of the screened genes with an overall prevalence of 35% and the highest prevalence percentage was observed for goats (56.76%) followed by avian species (chicken, duck and wild birds) (42.5%). Virulence-associated genes were observed across all animal host species. The study reports the presence of luks/pv, a gene encoding the PVL toxin previously described to be a marker for community acquired-MRSA, suggesting the crossing of species between human and livestock. The high prevalence of S. aureus from the livestock indicates a major food security and healthcare threat. This threat is further compounded by the virulence of the pathogen, which causes numerous clinical manifestations. The phenomenon of co-selection is observed in this study as isolates exhibited resistance to both antibiotics and heavy metals. Further, all the screened antibiotic and heavy metal resistance genes did not correspond with the phenotypic resistance.
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Affiliation(s)
- Chumisa C Dweba
- Discipline of Genetics, School of Life Sciences, College of Agriculture Engineering and Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.
| | - Oliver T Zishiri
- Discipline of Genetics, School of Life Sciences, College of Agriculture Engineering and Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.
| | - Mohamed E El Zowalaty
- Infectious Diseases and Anti-Infective Therapy Research Group, Sharjah Medical Research Institute and College of Pharmacy, University of Sharjah, Sharjah 27272, UAE.
- Department of Infectious Diseases, St. Jude Children's Research Hospital, 262 Danny Thomas Pl, Memphis, TN 38105, USA.
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20
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Donkor ES, Dayie NT, Tette EMA. Methicillin-Resistant Staphylococcus aureus in Ghana: Past, Present, and Future. Microb Drug Resist 2019; 25:717-724. [DOI: 10.1089/mdr.2018.0115] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Eric S. Donkor
- Department of Medical Microbiology, University of Ghana, Accra, Ghana
| | | | - Edem M. A. Tette
- Department of Community Health, University of Ghana, Accra, Ghana
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21
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Darboe S, Dobreniecki S, Jarju S, Jallow M, Mohammed NI, Wathuo M, Ceesay B, Tweed S, Basu Roy R, Okomo U, Kwambana-Adams B, Antonio M, Bradbury RS, de Silva TI, Forrest K, Roca A, Lawal BJ, Nwakanma D, Secka O. Prevalence of Panton-Valentine Leukocidin (PVL) and Antimicrobial Resistance in Community-Acquired Clinical Staphylococcus aureus in an Urban Gambian Hospital: A 11-Year Period Retrospective Pilot Study. Front Cell Infect Microbiol 2019; 9:170. [PMID: 31192162 PMCID: PMC6540874 DOI: 10.3389/fcimb.2019.00170] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/06/2019] [Indexed: 11/13/2022] Open
Abstract
Background:Staphylococcus aureus is a major human pathogen. Panton-Valentine leukocidin (PVL) is a virulence factor produced by some strains that causes leukocyte lysis and tissue necrosis. PVL-associated S. aureus (PVL-SA) predominantly causes skin and soft-tissue infections (SSTIs) but can also cause invasive infections such as necrotizing pneumonia. It is carried by both community-associated methicillin susceptible S. aureus (CA-MSSA) and methicillin resistant S. aureus (CA-MRSA). This study aims to determine the prevalence of PVL-SA among patients seen at an urban Gambian hospital and associated antibiotic resistance. Methods: Archived clinical S. aureus (70 invasive bacteraemia and 223 non-invasive SSTIs) from 293 patients were retrieved as well as relevant data from clinical records where available. Antibiotic susceptibility was assessed using disc diffusion according to Clinical Laboratory Standards Institute (CLSI) guidelines. Genomic DNA was extracted and the presence of lukF and lukS PVL genes was detected by conventional gel-based PCR. Result: PVL-SA strains accounted for 61.4% (180/293) of S. aureus isolates. PVL prevalence was high in both Gambian bacteraemia and SSTIs S. aureus strains. Antimicrobial resistance was low and included chloramphenicol (4.8%), cefoxitin (2.4%), ciprofloxacin (3.8%), erythromycin (8.9%), gentamicin (5.5%) penicillin (92.5%), tetracycline (41.0%), and sulfamethoxazole-trimethoprim (24.2%). There was no association of PVL with antimicrobial resistance. Conclusion: PVL expression is high among clinical S. aureus strains among Gambian patients. Reporting of PVL-SA clinical infections is necessary to enable the monitoring of the clinical impact of these strains in the population and guide prevention of the spread of virulent PVL-positive CA-MRSA strains. SUMMARY Staphylococcus aureus (S. aureus) is a major human pathogen with several virulence factors. We performed a retrospective analysis to investigate the prevalence of one such virulence factor (PVL) amongst clinical S. aureus samples. We found a high prevalence in our setting but antimicrobial resistance including methicillin resistance was low.
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Affiliation(s)
- Saffiatou Darboe
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | | | - Sheikh Jarju
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Mamadou Jallow
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Nuredin Ibrahim Mohammed
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Miriam Wathuo
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Buntung Ceesay
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Sam Tweed
- The School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Robindra Basu Roy
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Uduak Okomo
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Brenda Kwambana-Adams
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Martin Antonio
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Richard S. Bradbury
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Thushan I. de Silva
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Karen Forrest
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Anna Roca
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Bolarinde Joseph Lawal
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Davis Nwakanma
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Ousman Secka
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
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22
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A molecular epidemiological investigation of methicillin-susceptible Staphylococcus aureus causing bloodstream infections in Ireland, 2006–2017. Eur J Clin Microbiol Infect Dis 2019; 38:927-936. [DOI: 10.1007/s10096-019-03523-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/27/2019] [Indexed: 01/28/2023]
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23
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Donkor ES, Kotey FCN, Dayie NTKD, Duodu S, Tetteh-Quarcoo PB, Osei MM, Tette EMA. Colonization of HIV-Infected Children with Methicillin-Resistant Staphylococcus aureus. Pathogens 2019; 8:E35. [PMID: 30884909 PMCID: PMC6470964 DOI: 10.3390/pathogens8010035] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/17/2019] [Accepted: 02/21/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) poses a public health threat owing to its extensive resistance to antibiotics, association with persistent outbreaks, and markedly increased healthcare costs. Moreover, HIV-infected individuals are at a greater risk for colonization with MRSA, and may act as reservoirs for subsequent transmission to other individuals. In Ghana, little is known about MRSA in relation to at-risk populations, such as HIV-infected children. The aim of this study was to investigate nasal carriage of S. aureus and MRSA among HIV-infected children in Accra, including the prevalence, risk factors and antibiotic resistance. METHODOLOGY The study was cross-sectional, and involved 107 children with HIV infection and an equal number of sex- and age group- matched apparently healthy controls recruited from the Princess Marie Louis Children's Hospital in Accra. Nasal swab specimens were collected from the study participants and cultured for bacteria. S. aureus isolates were confirmed by the coagulase test while MRSA was confirmed by PCR of the mecA gene. Antimicrobial susceptibility testing of S. aureus isolates was done by the Kirby Bauer method. A structured questionnaire was used to collect data on demographic, household and clinical features of the study participants. A logistic regression analysis was performed to identify determinants of S. aureus and MRSA carriage among participants of both study groups. RESULTS The carriage prevalence of S. aureus and MRSA were 44.9% (48) and 5.6% (6), respectively, among the HIV-infected individuals, and the corresponding values within the control group were 23.4% (25) and 0.9% (1). There was a significant association between HIV infection and S. aureus colonization (p < 0.001), but not MRSA colonization (p = 0.055). The main predictor of S. aureus colonization in both study groups was absence of colonization with coagulase negative staphylococcus (p < 0.001). Furthermore, the main predictor of MRSA colonization was regular hand washing with soap (p = 0.043); this was observed among HIV-infected individuals but not the control group. The proportion of S. aureus isolates that were multidrug resistant was 62.3% (33/53) in the HIV-infected group and 80% (20/25) in the control group (p = 0.192). CONCLUSIONS HIV infection is a risk factor for nasal colonization of S. aureus among children in Accra but may not be for MRSA. Both the HIV-infected and uninfected children are reservoirs of multidrug resistant S. aureus. Demographic, household and clinical features appear to have little or no relationship with S. aureus and MRSA colonization in the study children.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, P. O. Box LG 54, Legon, Accra, Ghana.
| | - Fleischer C N Kotey
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
- FleRhoLife Research Consult, P. O. Box TS 853, Teshie, Accra, Ghana.
| | - Nicholas T K D Dayie
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, P. O. Box LG 54, Legon, Accra, Ghana.
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, P. O. Box LG 54, Legon, Accra, Ghana.
| | - Patience B Tetteh-Quarcoo
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
| | - Mary-Magdalene Osei
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
| | - Edem M A Tette
- Department of Community Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana.
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24
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Kazimoto T, Abdulla S, Bategereza L, Juma O, Mhimbira F, Weisser M, Utzinger J, von Müller L, Becker SL. Causative agents and antimicrobial resistance patterns of human skin and soft tissue infections in Bagamoyo, Tanzania. Acta Trop 2018; 186:102-106. [PMID: 30006029 DOI: 10.1016/j.actatropica.2018.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 07/08/2018] [Accepted: 07/09/2018] [Indexed: 11/29/2022]
Abstract
Few epidemiological studies have been carried out to assess the aetiology and antimicrobial susceptibility patterns of pathogens giving rise to skin and soft tissue infections (SSTIs) in sub-Saharan Africa. In the present study from six healthcare facilities in Bagamoyo, Tanzania, wound swabs from outpatients with SSTIs were analysed by a suite of methods, including microbiological culture techniques, matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry and resistance testing. Among 185 patients with SSTIs, 179 (96.8%) swabs showed microbiological growth. In total, 327 organisms were found, of which 285 were of potential aetiological relevance. Staphylococcus aureus was the predominant pathogen (prevalence: 71.4%), followed by the Gram-negative bacteria Enterobacter cloacae complex (14.6%), Klebsiella pneumoniae (12.4%) and Pseudomonas aeruginosa (11.8%). While one out of three isolates of S. aureus showed resistance to macrolides, tetracyclines, cotrimoxazole and clindamycin, only a single methicillin-resistant S. aureus (MRSA) strain was found. In Gram-negative bacteria, resistance to ampicillin and cotrimoxazole was common, while extended-spectrum beta-lactamases were rarely detected (<1%). We conclude that S. aureus was the most frequently detected pathogen in community-acquired SSTIs in Bagamoyo, Tanzania. Resistance to commonly prescribed oral antibiotics was considerable, but multi-resistant strains were rarely encountered. Monitoring of antibiotic susceptibility patterns in SSTIs is important to provide specific data for tailoring treatment recommendations.
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Affiliation(s)
- Theckla Kazimoto
- Ifakara Health Institute, Bagamoyo Branch, P.O. Box 74, Bagamoyo, Tanzania; Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Straße, Building 43, 66421 Homburg/Saar, Germany.
| | - Salim Abdulla
- Ifakara Health Institute, Bagamoyo Branch, P.O. Box 74, Bagamoyo, Tanzania
| | - Leah Bategereza
- Ifakara Health Institute, Bagamoyo Branch, P.O. Box 74, Bagamoyo, Tanzania
| | - Omar Juma
- Ifakara Health Institute, Bagamoyo Branch, P.O. Box 74, Bagamoyo, Tanzania
| | - Francis Mhimbira
- Ifakara Health Institute, Bagamoyo Branch, P.O. Box 74, Bagamoyo, Tanzania
| | - Maja Weisser
- Ifakara Health Institute, Bagamoyo Branch, P.O. Box 74, Bagamoyo, Tanzania; Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland; Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Lutz von Müller
- Institute for Laboratory Medicine, Microbiology and Hygiene, Christophorus Kliniken, Südring 41, 48653 Coesfeld, Germany
| | - Sören L Becker
- Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Straße, Building 43, 66421 Homburg/Saar, Germany; Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland
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25
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Amissah NA, van Dam L, Ablordey A, Ampomah OW, Prah I, Tetteh CS, van der Werf TS, Friedrich AW, Rossen JW, van Dijl JM, Stienstra Y. Epidemiology of Staphylococcus aureus in a burn unit of a tertiary care center in Ghana. PLoS One 2017; 12:e0181072. [PMID: 28704546 PMCID: PMC5509299 DOI: 10.1371/journal.pone.0181072] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/26/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In developing countries, hospitalized burn victims are at high risk of nosocomial infections caused by Staphylococcus aureus. Risk factors include poor infection control practices, prolonged hospitalisation and limited capacity for laboratory microbiological analyses. These problems are compounded by widespread use of antibiotics that drives the spread of multi-drug resistant bacteria. METHODS During the study period (November 2014-June 2015), nasal and invasive S. aureus isolates were collected consecutively from patients and healthcare workers (HCWs) within the burn unit of the Reconstructive Plastic Surgery and Burn Center of Korle Bu Teaching Hospital in Ghana. Antibiotic prescription, antibiotic susceptibility and bacterial typing were used to assess antibiotic pressure, antibiotic resistance, and possible transmission events among patients and HCWs. RESULTS Eighty S. aureus isolates were obtained from 37 of the 62 included burn patients and 13 of the 29 HCWs. At admission, 50% of patients carried or were infected with S. aureus including methicillin resistant S. aureus (MRSA). Antibiotic use per 100 days of hospitalization was high (91.2 days), indicating high selective pressure for resistant pathogens. MRSA isolates obtained from 11 patients and one HCW belonged to the same spa-type t928 and multi-locus sequence type 250, implying possible transmission events. A mortality rate of 24% was recorded over the time of admission in the burn unit. CONCLUSION This study revealed a high potential for MRSA outbreaks and emergence of resistant pathogens amongst burn patients due to lack of patient screening and extended empirical use of antibiotics. Our observations underscore the need to implement a system of antibiotic stewardship and infection prevention where microbiological diagnostics results are made available to physicians for timely and appropriate patient treatment.
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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
| | - Lieke van Dam
- 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
| | - Opoku-Ware Ampomah
- The Reconstructive Plastic Surgery and Burn Center, Korle Bu Teaching Hospital, Korle Bu, Ghana
| | - Isaac Prah
- 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
| | - Tjip S. van der Werf
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Alexander W. Friedrich
- Department of Medical Microbiology, 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
| | - 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
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