Molecular Characterizations of the Coagulase-Negative Staphylococci Species Causing Urinary Tract Infection in Tanzania: A Laboratory-Based Cross-Sectional Study

Abstract

Background: There is a growing body of evidence on the potential involvement of coagulase-negative Staphylococci (CoNS) in causing urinary tract infections (UTIs). The aim of this study was to delineate virulence potential, antimicrobial resistance genes, and sequence types of CoNS isolated from patients with UTI symptoms and pyuria in Tanzania. Methods: CoNS from patients with UTI symptoms and more than 125 leucocytes/μL were retrieved, subcultured, and whole-genome sequenced. Results: Out of 65 CoNS isolates, 8 species of CoNS were identified; Staphylococcus haemolyticus, n = 27 (41.5%), and Staphylococcus epidermidis, n = 24 (36.9%), were predominant. The majority of S. haemolyticus were sequence type (ST) 30, with 8 new ST138-145 reported, while the majority of S. epidermidis were typed as ST490 with 7 new ST1184-1190 reported. Sixty isolates (92.3%) had either one or multiple antimicrobial resistance genes. The most frequently detected resistance genes were 53 (21%) dfrG, 32 (12.9%) blaZ, and 26 (10.5%) mecA genes conferring resistance to trimethoprim, penicillin, and methicillin, respectively. Out of 65 isolates, 59 (90.8%) had virulence genes associated with UTI, with a predominance of the icaC 47 (46.5%) and icaA 14 (13.9%) genes. Conclusion:S. haemolyticus and S. epidermidis harboring icaC, dfrG, blaZ, and mecA genes were the predominant CoNS causing UTI in Tanzania. Laboratories should carefully interpret the significant bacteriuria due to CoNS in relation to UTI symptoms and pyuria before labeling them as contaminants. Follow-up studies to document the outcome of the treated patients is needed to add more evidence that CoNS are UTI pathogens.

Whole Genome Sequence Analysis of Two Oxacillin-Resistant and mecA-Positive Strains of Staphylococcus haemolyticus Isolated from Ear Swab Samples of Patients with Otitis Media

“… 3 , 27 However, the prevalence of ST3 has continuously decreased since 2013. 26 In addition, S. haemolyticus strains belonging to ST30 have been previously detected in different clinical samples of the urinary tract, 28 infected eyes, 29 nares, 3 feces, 3 and blood. 30 …”

“…3,27 However, the prevalence of ST3 has continuously decreased since 2013. 26 In addition, S. haemolyticus strains belonging to ST30 have been previously detected in different clinical samples of the urinary tract, 28 infected eyes, 29 nares, 3 feces, 3 and blood. 30 In our study, two strains of oxacillin-resistant S. haemolyticus were found to carry the mecA gene, which confers methicillin resistance and is usually acquired through a SCCmec element in methicillin-resistant strains of staphylococci.…”

Improving the diagnosis of urinary tract infections by the use of enriched media and a 48-hour incubation period

“…Similarly, failing to consider the sample collection method or patient symptoms makes it difficult to identify whether a microorganism is a contaminant or a causative agent of infection, again providing misleading results. Normally, saprophytic microorganisms that colonize the skin are regarded as contaminants, but in certain circumstances, they should be treated as opportunistic pathogens, as in the case of coagulase-negative staphylococci [21].…”