High prevalence of Panton-Valentine leukocidin positive, multidrug resistant, Methicillin-resistant Staphylococcus aureus strains circulating among clinical setups in Adamawa and Far North regions of Cameroon

Abstract

Staphylococcus aureus (S. aureus) is one of the earliest pathogens involved in human infections, responsible for a large variety of pathologies. Methicillin was the first antibiotic used to treat infections due to S. aureus but infections due to Methicillin resistant Staphylococcus aureus (MRSA) originated from hospital settings. Later, severe infections due to MRSA without any contact with the hospital environment or health care workers arose. Prevalence of MRSA has shown an alarming increase worldover including Cameroon. This Cross-sectional study was designed to evaluate the occurrence of MRSA infections in five different, most frequented Hospitals in northern Cameroon. Socio demographic data was recorded through questionnaire and different clinical specimens were collected for bacterial isolation. Identification of S. aureus was confirmed via 16s rRNA amplification using S. aureus specific primers. Molecular characterisation was performed through mecA gene, Luk PV gene screening and SCCmec typing. A total of 380 S. aureus clinical isolates were obtained of which 202 (53.2%) were nonduplicate multidrug resistant isolates containing, 45.5% MRSA. Higher number of MRSA was isolated from pus (30.4%) followed by blood culture (18.5%), and urine (17.4%). Patients aged 15 to 30 years presented high prevalence of MRSA (30.4%). Majority isolates (97.8%) carried the mecA gene, PVL toxin screening indicated 53.3% isolates carried the lukPV gene. Based on PVL detection and clinical history, CA-MRSA represented 53.3% of isolates. SCCmec typing showed that the Type IV was most prevalent (29.3%), followed by type I (23.9%). Amongst MRSA isolates high resistance to penicillin (91.1%), cotrimoxazole (86.7%), tetracycline (72.2%), and ofloxacin (70.0%) was detected. Meanwhile, rifampicin, fusidic acid, lincomycin and minocycline presented high efficacy in bacterial control. This study revealed a high prevalence of MRSA among infections due to S. aureus in Northern Cameroon. All MRSA recorded were multidrug resistant and the prevalence of CA MRSA are subsequently increasing, among population.

Antibiotic Susceptibility Profiling of Human Pathogenic Staphylococcus aureus Strains Using Whole Genome Sequencing and Genome-Scale Annotation Approaches

“…Each row represents the aligned sample. Panton-Valentine leukocidin (PVL) toxin is a virulence factor in S. aureus associated with deep skin and soft-tissue infections (furunculosis, cutaneous abscesses, and severe necrotizing pneumonia) [68][69][70]. In 1932, Panton and Valentine defined the PVL as a virulence factor in the family of synergohymenotropic toxins in S. aureus [71].…”

A mapping review of methicillin-resistant Staphylococcus aureus proportions, genetic diversity, and antimicrobial resistance patterns in Cameroon

“…Finally, 24 studies were included in our review and met the criteria for MRSA proportions, genetic diversity, and antimicrobial resistance patterns in Cameroon [13,. Among the included studies, there were 22 studies on human MRSA epidemiology [13,[20][21][22][23][24][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41], one study on animal epidemiology [25], two studies on food epidemiology [19,21], one study on environmental epidemiology [38].…”

“…In addition, one study included the Central and Southwest regions (4.1%) [39], and another focused on the Northwest and Southwest regions (4.1%) [19]. One study included all regions (4.1%) [33], and another covered the Adamawa and Far North regions (4.1%) [34]. Finally, two studies did not contain clear regional information [25,40].…”

“…Patients with skin and soft tissue infections had a prevalence of 13.2% [20], and those with suppurating wounds or abscesses reported 17.3% [31]. A broad spectrum was observed among patients with various diseases, with rates spanning from 13.4% to 46.8% [27,30,34,35,39]. Pregnant and non-pregnant individuals presented a rate of 41.1% [36], while mixed populations presented diverse prevalence ranging from 2.8% to 34.6% [24,26,32,38].…”

“…Aminoglycoside resistance was reported in several studies. For gentamicin, resistance rates ranged from 22.2% in Dschang [31] to 55.4% in an unspecified location [34]. Resistance to amikacin was relatively low, with no resistance observed in Douala and Buea, and a 42.9% resistance rate in Yaounde [20,21,31,34,37].…”