BackgroundStaphylococcus aureus is an important pathogen causing a wide range of infections in the hospital and community setting. In order to have adequate information for treatment of S. aureus infections, it is crucial to understand the trends in the antibiotic-resistance patterns. In addition, the occurrence and changes in types of S. aureus, clonal identities, and their geographic spread is essential for the establishment of adequate infection control programmes. In this study, 68 S. aureus isolates obtained from clinical and non-clinical sources in Nigeria between January and April 2009 were characterized using phenotypic and molecular methods.ResultsAll the S. aureus isolates were susceptible to teicoplanin, vancomycin, phosphomycin, fusidic acid, rifampicin, daptomycin, mupirocin, linezolid and tigecycline. Sixteen percent of the isolates were resistant to oxacillin, while 55% and 72% of isolates were resistant to tetracycline and trimethoprim/sulphamethoxazole (cotrimoxazole), respectively (Table 1). There was excellent correlation between the broth microdilution assay and detection of antibiotic resistance genes by the multiplex PCR, in the determination of S. aureus resistance to erythromycin, gentamicin, methicillin and tetracycline. A total of 28 spa types were identified in the study, and the predominant spa type among the methicillin-susceptible S. aureus (MSSA) isolates was t084 (13 isolates). The t037-ST241-SCCmecIII type was the only clone identified in Maiduguri (North-East Nigeria) while in South-West Nigeria, diversity among the MRSA isolates (t451-ST8-SCCmecV; t008-ST94-SCCmecIV; t002-ST5-SCCmecV; t064-ST8-SCCmecV) was observed. The toxin genes seh and etd were detected in isolates affiliated with clonal complexes CC1, CC80 and sequence type ST25, respectively. The proportion of PVL-positive isolates among MSSA was high (40%). Most of the PVL-positive MSSA isolates were obtained from wound infections and associated with clonal complexes CC1, CC30, CC121 and with sequence type ST152.Table 1Antibiotic resistance profile of S. aureus (MSSA and MRSA) from NigeriaNumber (%) of resistant isolates among:AntibioticMSSA(n = 57)MRSA(n = 11)Total(n = 68)Penicillin49 (86)11 (100)60 (88.2)Oxacillin0 (0)11 (100)11 (16.2)Teicoplanin0 (0)0 (0)0 (0)Vancomycin0 (0)0 (0)0 (0)Gentamicin1 (1.8)9 (81.8)10 (14.7)Tetracycline27 (47.4)11 (100)38 (55.9)Ciprofloxacin12 (21.1)8 (72.7)20 (29.4)Moxifloxacin0 (0)7 (63.6)7 (10.3)Trimethoprim/sulfamethoxazole39 (68.4)10 (90.9)49 (72.1)Phosphomycin0 (0)0 (0)0 (0)Fusidic acid0 (0)0 (0)0 (0)Erythromycin2 (3.5)6 (54.5)8 (11.8)Clindamycin0 (0)6 (54.5)6 (8.8)Rifampicin0 (0)0 (0)0 (0)Daptomycin0 (0)0 (0)0 (0)Mupirocin0 (0)0 (0)0 (0)Linezolid0 (0)0 (0)0 (0)Tigecycline0 (0)0 (0)0 (0)ConclusionsThe use of phenotypic and molecular methods provided useful information on antibiotic resistance and molecular diversity of S. aureus in Nigeria. The high proportion of PVL-positive MSSA isolates affiliated to various clonal complexes and detected in all the health institutions is a major conc...

Background: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection is a global pandemic. Healthcare workers' (HCWs) role in patient management is predisposing and can serve as means of hospitals and community transmission. This study evaluated HCWs' knowledge, attitude, and practice towards COVID-19 in Nigeria. Methods: we carried out a cross-sectional survey among HCWs during the COVID-19 outbreak in Nigeria from March to June 2020. The study assessed 346 HCWs for Knowledge, attitude, and practice by using an online (Google form) self-administered questionnaire, based on a convinience sampling technique Data were retrieved and analyzed using descriptive statistics. Chi-Square and one-way ANOVA were used to measure association and difference among demographic variables. The relationship between knowledge, attitude, and practice was measured using Spearman's rho correlation test. Results: the mean knowledge score of the HCWs was 7.1 on a scale of 0-8. The correct overall rate of the knowledge questionnaire was 88.75%. Knowledge was gained mainly from television (35.0%) and social media (35.0%). The mean attitude score on a scale of 0-6 was 5.31 AE 0.39. Most (92.5%) participants were confident that Nigerian medical scientists would win the war against COVID-19. The majority (92.2%) of the respondents thought that SARS-CoV-2 was not a biological weapon. About 1 out of 5 respondents held that faith healing or prayer is the only cure for COVID-19. A vast majority of the HCWs were taking precautionary measures such as avoiding crowded places (94.2%), washing of hands (96.0%), and the use of personal protective equipment (91.6%) against SARS-CoV-2 infection. Nevertheless, only 3 out of 5 HCWs used a face mask when leaving home. There was a significant (p ¼ 0.046) positive correlation (0.584) between knowledge and attitude. Conclusion: our results showed that HCWs in Nigeria had excellent knowledge and possessed a positive attitude and good practice towards COVID-19. However; there were areas where poor knowledge, negative attitudes and unacceptable practices were observed. We recommend continuous public health education of HCWs on SARS-COV-2 infection control and prevention.

BackgroundThe staphylococci are implicated in a variety of human infections; however, many clinical microbiology laboratories in Nigeria do not identify staphylococci (in particular coagulase negative staphylococci - CNS) to the species level. Moreover, data from multi-centre assessment on antibiotic resistance and epidemiology of the staphylococci are not available in Nigeria. This study investigated 91 non-duplicate staphylococcal isolates obtained from the microbiology laboratories of eight hospitals in Nigeria during the period January to April 2010.MethodsIdentification and antibiotic susceptibility testing was performed using the VITEK 2 system, detection of resistance genes by PCR, and molecular characterization was determined by SCCmec typing, spa and multilocus sequence typing (MLST).ResultsAll the isolates were susceptible to mupirocin, tigecycline, vancomycin and linezolid, but 72.5% of CNS and 82.3% of Staphylococcus aureus were resistant to cotrimoxazole, while multiresistance was observed in 37 of the 40 CNS isolates. Untypeable SCCmec types (ccrC/Class A mec and ccr-negative/Class C2 mec gene complex) in two methicillin-resistant S. aureus (MRSA) were identified. Additionally, ccr-negative/Class A mec and ccr type 4/Class C2 mec gene complex was detected in one isolate each of S. sciuri and S. haemolyticus, respectively. The S. aureus isolates were classified into 21 spa types including two new types (t8987, t9008) among the methicillin-susceptible S. aureus (MSSA) isolates. Two (CC8-SCCmecnon-typeable and CC88-SCCmec IV) and four (CC8-SCCmec III/IV/V; CC30-SCCmec II/III; CC88-SCCmec IV; and ST152-SCCmecnon-typeable) MRSA clones were identified in Maiduguri (North-East Nigeria) and South-West Nigeria, respectively. The proportion of Panton-Valentine leukocidin (PVL)-positive MSSA was high (44.4%) and 56.3% of these strains were associated with sequence type (ST) 152.ConclusionsThe identification of multiresistant mecA positive S. haemolyticus and S. sciuri from clinical samples indicates that characterization of CNS is important in providing information on their diversity and importance in Nigeria. There is the need to develop new SCCmec classification methods for non-typeable methicillin-resistant staphylococci, and to curtail the spread and establishment of the S. aureus ST152 clone in Nigeria. The study presents the first report of a PVL-positive ST152-SCCmecnontypeable MRSA and SCCmec typing of methicillin-resistant CNS in Nigeria.

Ninety-six clinical isolates ofStaphylococcus aureus is a major cause of both hospital-and community-acquired infections. In particular, methicillin (meticillin)-resistant S. aureus (MRSA) strains have been detected worldwide (15), and the prevalence of MRSA varies among countries and health institutions (2,4,27). The emergence of MRSA strains resistant to glycopeptides, as well as the increasing prevalence in the community (7), highlights the need for worldwide epidemiological studies of this pathogen. However, data about the epidemiology and prevalence of staphylococcal infections in Africa are scarce compared to information about such infections in the rest of the world. Studies have indicated low prevalences of MRSA in Nigeria, Somalia, and Tanzania (1), but high prevalences in South Africa, Zimbabwe, Kenya, Ethiopia, Egypt, Senegal, and the Ivory Coast have been reported (2,9,18). In addition, a recent study of the genetic diversity of S. aureus strains in a carriage population from Mali showed a high frequency of a PantonValentine leukocidin (PVL)-positive clone (25). The mechanisms for the emergence and spread of S. aureus clones in Africa are largely unknown; hence, the characterization of isolates may provide baseline information needed in establishing effective infection control measures in Nigeria.In this study, a total of 96 S. aureus isolates obtained between January and December 2007 from clinical specimens in six tertiary-care hospitals located in northeastern Nigeria were characterized. The isolates were identified based on standard bacteriological procedures (i.e., Gram staining and catalase, tube coagulase, and DNase testing), and susceptibilities to 12 antibiotics (Table 1) were determined by the disk diffusion method according to the CLSI guidelines. All the isolates were susceptible to vancomycin, fusidic acid, and mupirocin, and 12 (12.5%) were resistant to methicillin (i.e., oxacillin and cefoxitin resistant) ( Table 1). The MRSA isolates were multidrug resistant (i.e., resistant to beta-lactams, along with at least three other classes of antibiotics), a finding similar to previously reported findings in other African countries like Morocco, Kenya, Cameroon, and South Africa (17). MRSA resistance to non-beta-lactams may further increase the medical expenses and the complexity of patient management, as well as morbidity and mortality rates since alternative antibiotics may not be affordable in many African countries.The genetic diversity of the S. aureus population was assessed by the highly discriminatory double-locus sequence typing (DLST) method as described previously (20). This method is based on the analysis of partial sequences (about 500 bp) of the variable clfB and spa genes. A total of 41 clfB and 46 spa alleles were observed among the 96 S. aureus isolates evaluated by DLST, and these alleles represented 53 different DLST types. The eBURST software was used to cluster DLST types with identical sequences of at least one allele. Cluster analysis showed a low level of diversity amon...

This study determined the methicillin-resistant Staphylococcus aureus (MRSA) colonization rate among ruminant animals slaughtered for human consumption and contact persons. Nasal and milk product samples were collected from the main abbatoir in Maiduguri and analyzed using standard bacteriological procedures. A total of 510 samples were analyzed, 87 (17.1%) S. aureus isolates were identified, 33 (34.6%) MRSA and 54 (65.9%) methicillin-sensitive Staphylococcus aureus (MSSA) isolates were detected. 19 (21.8%) MRSA and 17 (19.5) MSSA strains were recovered from cattle, 10 (12.5%) MRSA isolates were recovered from the Red Bororo cattle breed and 12 (17.1) MSSA from carmelius dromedarius. In overall antimicrobial susceptibility pattern, MRSA isolates exhibited multidrug resistance pattern, moderate susceptibility to ciprofloxacin (42.2%), tobramycin (36.4%), amikacin (36.4%), streptomycin (42.2%), while majority of MSSA isolates demonstrated high sensitivity pattern (>70%). Six (6.9%) S. aureus isolates (2 MRSA from cattle and 4 MSSA from sheep) exhibited inducible phenotype.In conclusion, the study findings reveal a relatively high MRSA colonization rate and unique resistance pattern, particularly to topical antimicrobial agents (fusidic acid, mupirocin) that are not routinely used in veterinary medical practice in the study area. The study findings provides a baseline epidemiological information for better understanding of MRSA infections in human and veterinary medicine including foods of animal origin.

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The population structure of Staphylococcus aureus is changing globally but the situation regarding dominant clones in sub-Saharan Africa is not clear. We therefore assessed changes in the population structure of clinical S. aureus isolates obtained in 2007 (n = 75) and 2012 (n = 75) from Northeastern Nigeria. A reduction in resistance to penicillin, gentamicin, erythromycin and clindamycin was observed in 2012. A decrease of methicillin resistance rates (13·3% to 8·0%) was associated with the decline of the ST241 MRSA clone. The proportion of Panton-Valentine leukocidin (PVL)-positive isolates also decreased from 65·3% to 44%, and was linked with the emergence of PVL-negative ST601 clone in 2012. The significant decline in antibiotic resistance in the study area is in contrast to the worldwide trend of increasing resistance rates.

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