Hospital Epidemiology of Methicillin-ResistantStaphylococcus aureusin a Tertiary Care Hospital in Moshi, Tanzania, as Determined by Whole Genome Sequencing

Abstract

Objective To determine molecular epidemiology of methicillin-resistant S. aureus in Tanzania using whole genome sequencing. Methods DNA from 33 Staphylococcus species was recovered from subcultured archived Staphylococcus isolates. Whole genome sequencing was performed on Illumina Miseq using paired-end 2 × 250 bp protocol. Raw sequence data were analyzed using online tools. Results Full susceptibility to vancomycin and chloramphenicol was observed. Thirteen isolates (43.3%) resisted cefoxitin and other antimicrobials tested. Multilocus sequence typing revealed 13 different sequence types among the 30 S. aureus isolates, with ST-8 (n = seven, 23%) being the most common. Gene detection in S. aureus stains were as follows: mecA, 10 (33.3%); pvl, 5 (16.7%); tst, 2 (6.7%). The SNP difference among the six Tanzanian ST-8 MRSA isolates ranged from 24 to 196 SNPs and from 16 to 446 SNPs when using the USA300_FPR3757 or the USA500_2395 as a reference, respectively. The mutation rate was 1.38 × 10−11 SNPs/site/year or 1.4 × 10−6 SNPs/site/year as estimated by USA300_FPR3757 or the USA500_2395, respectively. Conclusion S. aureus isolates causing infections in hospitalized patients in Moshi are highly diverse and epidemiologically unrelated. Temporal phylogenetic analysis provided better resolution on transmission and introduction of MRSA and it may be important to include this in future routines.

Methicillin-resistant Staphylococcus aureus (MRSA) in East Africa: red alert or red herring?

“…National data from 9 African countries shows MRSA rates to approximate between 12 and 80%, with some countries exceeding 82% [6, 8]. For example, in East Africa, high prevalence rates of between 31.5 to 42% among patients and healthcare workers have been recorded in Uganda [9, 10], 31 to 82% MRSA prevalence in Rwanda [11, 12], and in 10 to 50% in Tanzanian studies [13–21]. However, there have been some pockets of positive reports owing to antimicrobial stewardship and infection control practices such as South Africa, which recorded a modest decline from 34 to 28% since 2011 [6, 8, 22].…”

Genetic diversity and risk factors for the transmission of antimicrobial resistance across human, animals and environmental compartments in East Africa: a review

“…Most studies in East Africa have reported considerable genetic diversity and differences in sequence types of AMR genes particularly for ESBL (Table 2 , Fig. 1 ), MRSA (Table 3 ) [ 71 – 75 ], and CAR (Table 4 ). These are attributed to evolutionary events, including mutations, selection and gene transfer, in the AMR genes in MRSA, ESBL and carbapenem isolates.…”

“…Further, a cross sectional study in Kenya, reported predominance of SCCmec type V followed by SCCmecII genes in healthy students residing within the university residence halls [83]. Several sequence types (STs) of MRSA have been reported in East Africa [71,74,75,77]. For instance, the ST88 and ST1797 have been reported to be the predominant sequence types causing wound infection and abscesses in clinical isolates in a tertiary hospital in Tanzania [74].…”

“…[71][72][73][74][75], and CAR(Table 4). These are attributed to evolutionary events, including mutations, selection and gene transfer, in the AMR genes in MRSA, ESBL and carbapenem isolates.…”

Лекарственные средства, ингибирующие кворум-сенсинг бактерий Staphylococcus aureus

“…Микроорганизмы Staphylococcus aureus не случайно получили характеристику «двуликого Януса» [5], так как, представляя собой оппортунистические патогены, могут вызвать инфекционный процесс с тяжелым инвазивным течением. Так, открытые в 1961 году штаммы бактерий Staphylococcus aureus, резистентные к действию метициллина (methicillin-resistant Staphylococcus aureus -MRSA) [15], являются ведущей причиной тяжелых нозокомиальных инфекций в странах всего мира [18]. Особенно высокий риск развития MRSAассоциированных инфекций отмечается у недоношенных и новорожденных детей с очень низкой массой тела [43], для которых характерен низкий уровень экспрессии образраспознающих рецепторов [1].…”