Prevalence of Methicillin-Resistant Staphylococcus Species Among Filarial Lymphedema Patients in Ahanta West District of Ghana

Abstract

BackgroundFilarial pathologies such as lymphedema may be associated with complications such as chronic non-healing wounds. Nonetheless, the role of bacterial population colonizing the lymphedematous legs has been posited to worsen the conditions of those living with the infection. These bacteria are usually composed of staphylococcal species partly because they are commensals. Thus, this present study sought to type the methicillin-resistant Staphylococcus aureus (MRSA) prevalence among individuals presenting with filarial lymphedema, particularly as MRSA tends to affect treatments options.MethodsWe recruited individuals (n = 321) with stages I–VII of lymphedema in a cross-sectional study in the Ahanta West district of the Western Region of Ghana. Swabs from lymphedematous limb ulcers, pus, and cutaneous surfaces were cultured using standard culture-based techniques. The culture isolates were later identified using Matrix-assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) mass spectrometry.ResultsA total of 192 Staphylococci species were isolated, with an overall prevalence of 39.7% (95% CI: 35%–44%; N = 483). S. hominis was the most prevalent species (23.95%), followed by S. haemolyticus (20.83%), S. epidermidis (15.10%), S. aureus (10.41%), and S. saprophyticus (9.32%). The remaining 20.34% were distributed among S. wanneri, S. sciuri, S. pasteuri, S. xylosus, S. simulans, S. cohnii, S. caprae, S. lugdunensis, and S. capitis. MRSA, containing mecA gene, was detected in 21 out of 31 Staphylococci isolates tested, with an overall prevalence of 68% (95% CI: 51%–84%). In addition, a virulent gene, Panton–Valentine leukocidin (PVL), which is usually associated with S. aureus, was detected in 20/31 (64.5%) S. aureus in the study.ConclusionThese results suggest that MRSA species may pose a challenge to the treatment of filarial lymphedema with antibiotics particularly, as doxycycline is currently being piloted in some endemic areas to treat the infection. Thus, intensive antimicrobial resistance surveillance should be conducted in endemic areas by health authorities to forestall the dilemma of multidrug resistance not only against lymphatic filariasis (LF) infection but other diseases.

Multi-drug resistant bacteria isolates from lymphatic filariasis patients in the Ahanta West District, Ghana

“…An earlier report by Wireko et al . (2021) [ 50 ] hints at a possible horizontal gene transfer for mec A in lymphatic filariasis MRSA isolates, owning to the presence of mec A gene is Staphylococcus epidermidis , Staphylococcus haemolyticus and Staphylococcus hominis isolates [ 50 ]. However, transposons have also been shown to be responsible for the translocation of resistance genes in the staphylococcal cassette chromosome, making MRSA resistant to other antibiotics [ 57 ].…”

“…Sociodemographic data on age, occupation, marital status and sex were taken. Leg staging of participants were done as has been reported by [ 50 ]. Information of cause of wound and age of wound in months were done using a simple structured questionnaire.…”

Bacterial diversity significantly reduces toward the late stages among filarial lymphedema patients in the Ahanta West District of Ghana: A cross‐sectional study

“…In this study, we report a trend of resistance of Gram‐positive bacteria against tetracycline, chloramphenicol, and penicillin. Even though methicillin‐resistant S. aureus and vancomycin‐resistant enterococci are of great concern for public health institutions such as WHO, 39 as our group recently reported the increasing reports of resistant Gram‐positive bacteria to broad‐spectrum antibiotics such as penicillin and tetracycline should equally be of concern 21 …”

“…This study was cross‐sectional carried out in eight (8) LF‐endemic communities in the Ahanta West District, Ghana. Identification of microbial populations was performed as previously described 21 . The study communities were Akatakyi, Princess Town, Dixcove, Ampatano, Asemkow, Butre, Achowa, and Busia, which are LF hotspots located at the Western Region of Ghana (Figure 1).…”

“…aureus and vancomycin-resistant enterococci are of great concern for public health institutions such as WHO, 39 as our group recently reported the increasing reports of resistant Gram-positive bacteria to broad-spectrum antibiotics such as penicillin and tetracycline should equally be of concern. 21 These broad-spectrum antibiotics are usually the first line for individuals living with LF pathologies in endemic communities in Ghana, as these are the mainstay medications during the painful episodes of filarial attacks. Among the Gram-positive bacteria isolated in this study; it was observed that S. haemolyticus showed the highest resistance to the antimicrobial agents tested.…”