Clonal lineages detected amongst tetracycline-resistant meticillin-resistant Staphylococcus aureus isolates of a Tunisian hospital, with detection of lineage ST398

Elhani, Dalèle; Gharsa, Haythem; Kalai, Dhia; Lozano, Carmen; Gómez, Paula; Boutheina, Jemli; Aouni, Mahjoub; Barguellil, Farouk; Torres, Carmén; Slama, Karim Ben

doi:10.1099/jmm.0.000066

Cited by 22 publications

(26 citation statements)

References 45 publications

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“…The isolates were resistant to aminoglycosides, fluoroquinolones, macrolides, and lincosamides, with mechanisms of resistance, including mecA ( n = 24), tet (K) ( n = 6), tet (L) ( n = 1), and/or tet (M) ( n = 18), erm (A) ( n = 14), and aph(2 ′ )‐acc(6 ′) ( n = 13). Identified drug‐resistant strains included ST247 ( n = 12), ST239 ( n = 6), ST728 ( n = 2), ST241 ( n = 1), ST398 ( n = 1), ST5 ( n = 1), and ST641 ( n = 1) . For the first time, clonal lineage ST398, which has previously been reported in pigs from several studies in the United States, South America, Asia, and Canada, was found in an MRSA isolate in Africa from a nasal swab of a 74‐year‐old patient.…”

Section: Resultsmentioning

confidence: 75%

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Sekyere

Mensah

2019

Annals of the New York Academy of Sciences

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A systematic review of antibiotic‐resistant Gram‐positive bacteria in Africa from a One Health perspective is lacking. Here, we report result from a search for English‐language articles on the resistance mechanisms and clonality of Gram‐positive bacteria in Africa between 2007 and 2019 reported in PubMed, Web of Science, ScienceDirect, and African Journals OnLine; 172 studies from 22 different African countries were identified. Resistance genes, such as mecA, erm(B), erm(C), tet(M), tet(K), tet(L), vanB, vanA, vanC, and tet(O), were found to be common. Staphylococcus spp., Enterococcus spp., and Streptococcus spp. were the main species reported by the studies, with clones such as Staphylococcus aureus ST5 (n = 218 isolates), ST8 (n = 127 isolates), ST80 (n = 133 isolates), and ST88 (n = 117 isolates), and mobile genetic elements such as IS16 (n = 28 isolates), IS256 (n = 96), Tn916 (n = 107 isolates), and SCCmec (n = 4437 isolates) identified. SCCmec IV (n = 747 isolates) was predominant, followed by SCCmec III (n = 305 isolates), SCCmec II (n = 163 isolates), SCCmec V (n = 135 isolates), and SCCmec I (n = 79 isolates). Resistance to penicillin (n = 5926 isolates), tetracycline (n = 5300 isolates), erythromycin (n = 5151 isolates), rifampicin (n = 3823 isolates), gentamycin (n = 3494 isolates), sulfamethoxazole/trimethoprim (n = 3089 isolates), and ciprofloxacin (n = 2746 isolates) was common in most reports from 22 countries. Clonal dissemination of resistance across countries and between humans, animals, and the environment was observed. Resistance rates ranged from 1.4% to 100% for 15 of the studies; 10 were One Health–related studies. Strict infection control measures, antimicrobial stewardship, and periodic One Health epidemiological surveillance studies are needed to monitor and contain the threat of increasing antibiotic resistance in Africa.

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Section: Resultsmentioning

confidence: 75%

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Sekyere

Mensah

2019

Annals of the New York Academy of Sciences

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“…Crosscontamination of multi-drug resistant bacteria between patients and the environment accounted for the high rate of resistance in Algeria 45-49 . The high rate of ABR in Tunisia was attributed to cross contamination between hospital patients and hospital environment, immune deficiency 50 , overconsumption of antibiotics, heavy consumption of sheep meat, which is a reservoir of MRSA, and high consumptions of antibiotics in animal feed 51,52 . In Egypt, inappropriate antibiotic prescription practices 29 , inadequate hygienic handling and processing of food 12 , and close contact with pet dogs accounted for the high resistance 53 .…”

Section: Resultsmentioning

confidence: 99%

“…These isolates were resistant to aminoglycosides, fluoroquinolones, macrolides and lincosamide, with mechanisms of resistance including mecA (n=24) tet( K ) (n=6) tet (L) (n=1) and/or tet (M) (n=18), erm (A)(n=14), aph(2’)-acc(6’) (n=13). Identified drug-resistant strains included ST247 (n=12), ST239 (n=6), ST728 (n=2), ST241 (n=1), ST398 (n=1), ST5 (n=1) and ST641 (n=1) 50 . For the first time, clonal lineage ST398, which has been reported in pigs from several studies in USA, South America, Asia and Canada 100-103 , was found in human MRSA isolates in Africa in a nasal swab of a 74-year old patient.…”

Section: Resultsmentioning

confidence: 99%

Molecular Epidemiology and Mechanisms of Antibiotic Resistance in Gram-positive Bacteria in Africa: A Systematic Review and Meta-Analysis from a One Health Perspective

Mensah

2018

Preprint

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15 16 17 18 19 [2]HIGHLIGHTS 20  There is substantial resistance to antibiotics among Gram-positive bacteria (GPB) in Africa 21  Multidrug-resistant (MDR) S. aureus, E. faecium, E. faecalis, S. pyogenes, and S. 22 haemolyticus of the same clones were common in humans, animals and the environment. 23  MDR clones such as S. aureus ST5 and E. faecium ST80 were found in humans, animals and 24 the environment. 25  mecA, ermB, ermC, tetM/K/L, and vanA/B/C were common in GPB, including in VRSA. 26 Meta-analysis confirmed a high mean rate of drug resistance in GPB from humans (35.68%), 27 animals (69.63%) and the environment (88.33%) (p-value= 0.0301) in Africa. 28 SCCmec, IS16, and Tn916 mobilized mecA, ermB and tetM respectively across various GPB 29 species in animals, humans, and the environment. 30  A One Health approach to studying resistance mechanisms and molecular epidemiology of 31 antibiotic-resistant GPB is warranted. 32ABSTRACT 33 The emergence and dissemination of antibiotic resistance (ABR) in bacteria are being driven by 34 antibiotics use in humans, animals and the environment, threatening global health and 35 strengthening calls for a One Health approach to contain ABR. 36 A systematic search in PubMed for English research articles reporting on ABR in Gram-positive 37 bacteria in Africa within the last ten years from 2007 to 2017 was undertaken. This finally yielded 38 76 articles that were included in this review and all statistical analysis. [3]The same ABR Gram-positive bacterial clones, resistance genes, and mobile genetic elements 40 (MGEs) were found in humans, animals and the environment. IS16 and Tn916 were highly 41 associated with erm (B) and tet(M) in E. faecium (ST18, ST80 and ST910), S. agalactiae (ST612, 42 ST616 and ST617), E. faecalis and S. pyogenes (emm18, emm42, emm76 and emm118) whilst 43 SCCmec was associated with mecA in S. aureus (ST5, ST80, ST8, and ST88) and S. haemolyticus. 44 The resistance genes, mecA, erm (B), erm(C), tet(M), tet(K), tet(L), van(B), van(A), van(C), and 45 tet(O), were found in isolates from humans, animals and the environment. An ABR rate of 39.55% 46 in Gram-positive bacteria is estimated in Africa. Meta-analysis reveal that isolates were most 47 resistant to erythromycin (≥ 2 482) (37.37%), rifampicin (≥ 2 323) (33.42%), tetracycline (≥ 2 181) 48 (40.72%), penicillin (≥ 2 127) (73.47%), sulfamethoxazole/trimethoprim (≥1 377) (45.97%), 49 ciprofloxacin (≥846) (35.37%), gentamicin (≥805) (23.87%), vancomycin (≥712) (42.24%), 50 ampicillin (≥691) (48.25%), streptomycin (≥551) (32.03%) and chloramphenicol (≥376) (11.50%) 51 (p-value <0.0001). 52There is substantial resistance to antibiotics among Gram-positive bacteria in clinical and 53 environmental settings in Africa, mediated by clonal and polyclonal expansion as well as 54 horizontal transmission of resistance genes. A One Health approach to research, surveillance, and 55 molecular epidemiology, as well as antibiotic stewardship to contain ABR in humans, animals and ...

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“…Elhani et al [29] isolated one MRSA-ST398-t899 from the nasal sample of a farmer in Tunisia. According to the author, this was the first report of ST398 in humans in Africa.…”

Section: Discussionmentioning

confidence: 99%

Nasal carriage of sequence type 22 MRSA and livestock-associated ST398 clones in Tangier, Morocco

Mourabit¹,

Arakrak²,

Bakkali³

et al. 2017

J Infect Dev Ctries

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Introduction: This study aimed to provide data of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage as well as to determine the genetic lineages of this circulating MRSA in the Tangier community. Methodology: Between 2012 and 2013 two subpopulations consisting of randomly chosen healthy volunteers and outpatients in 11 healthcare facilities were screened. The antibiotic resistance phenotype was determined by disk diffusion. Toxin Panton-Valentin Leukocidin (PVL), toxic shock syndrome toxin-1 gene (tst), and mecA were detected by polymerase chain reaction (PCR). Nasal swabs were obtained from persons with no identified risk factors for MRSA acquisition. MRSA molecular typing was performed by pulsed-field gel electrophoresis (PFGE), staphylococcal chromosomal cassette mec, and Staphylococcus protein A (spa) typing. Results: A total of400 subjects (33.3%) were nasally colonized with S. aureus, and 17 (1.4%) were nasal carriers of MRSA. The analysis did not identify age, gender, and the two subpopulations as predictors for MRSA colonization. MRSA were more likely to harbor the tst gene (p < 0.05). This work highlighted a low prevalence of nasal MRSA carriage, with 52.94% belonging to sequence type (ST) ST22. The remaining isolates were distributed as singletons (ST8, ST1, and ST398), whereas approximately one-third of MRSA was not identified, including three novel spa-types (t13247, t13248, and t13249). Conclusions: Although we highlighted the current clones present in the Tangier community, they are limited in space and time. Therefore, further studies would be required to obtain a comprehensive picture of the dissemination of MRSA in the community, hospital, and livestock.

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Clonal lineages detected amongst tetracycline-resistant meticillin-resistant Staphylococcus aureus isolates of a Tunisian hospital, with detection of lineage ST398

Cited by 22 publications

References 45 publications

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Molecular Epidemiology and Mechanisms of Antibiotic Resistance in Gram-positive Bacteria in Africa: A Systematic Review and Meta-Analysis from a One Health Perspective

Nasal carriage of sequence type 22 MRSA and livestock-associated ST398 clones in Tangier, Morocco

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