scholarly journals Nasopharyngeal carriage, spa types and antibiotic susceptibility profiles of Staphylococcus aureus from healthy children less than 5 years in Eastern Uganda

2019 ◽  
Author(s):  
David Kateete ◽  
Benon B Asiimwe ◽  
Raymond Mayanja ◽  
Brian Mujuni ◽  
Freddie Bwanga ◽  
...  

Abstract Background: Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group and profession. This study aimed to determine the S. aureus carriage rate in children in Eastern Uganda, and identify S. aureus lineages that cause infection in Uganda. Methods: Nasopharyngeal samples from 742 healthy children less than 5 years residing in the Iganga/Mayuge Health & Demographic Surveillance Site in Eastern Uganda were processed for isolation of S. aureus. Antibiotic susceptibility testing based on minimum inhibitory concentrations (MICs) was determined by the BD PhoenixTM system. Genotyping was performed by spa typing. Results: The processed samples yielded 144 S. aureus isolates (one per child) therefore, the S. aureus carriage rate in children was 19.4% (144/742). Thirty one percent (45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All isolates were susceptible to rifampicin, vancomycin and linezolid. Moreover, all MRSA were susceptible to vancomycin, linezolid and clindamycin. Compared to methicillin susceptible S. aureus (MSSA) isolates (68.8%, 99/144), MRSA isolates were more resistant to non-beta-lactam antimicrobials –trimethoprim/sulfamethoxazole 73.3% (33/45) vs. 27.3% (27/99) [P<0.0001]; erythromycin 75.6% (34/45) vs. 24.2% (24/99) [P<0.0001]; chloramphenicol 60% (27/45) vs. 19.2% (19/99) [P<0.0001]; gentamicin 55.6% (25/45) vs. 25.3% (25/99) [P=0.0004]; and ciprofloxacin 35.6% (16/45) vs. 2% (2/99) [P<0.0001]. Furthermore, 42 MRSA (93.3%) were multidrug resistant (MDR) and one exhibited high-level resistance to mupirocin. Overall, 61 MSSA (61.6%) were MDR, including three mupirocin and clindamycin resistant isolates. Seven spa types were detected in MRSA, of which t037 & t064 were predominant and associated with SCCmec types I & IV, respectively. Fourteen spa types were detected in MSSA, of which t645 & t4353 were predominant. Conclusions: S. aureus carriage rate in healthy children in Eastern Uganda is high and comparable to rates for hospitalized patients in Kampala. The detection of mupirocin resistance is worrying as it could rapidly increase if mupirocin is administered in a low-income setting. S. aureus strains of spa types t064, t037 (MRSA) and t645, t4353 (MSSA) are prevalent and could be responsible for majority of staphylococcal infections in Uganda.

2019 ◽  
Author(s):  
David Kateete ◽  
Benon B Asiimwe ◽  
Raymond Mayanja ◽  
Brian Mujuni ◽  
Freddie Bwanga ◽  
...  

Abstract Background: Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group and profession. This study aimed to determine the S. aureus carriage rate in children in Eastern Uganda, and identify S. aureus lineages that cause infection in Uganda. Methods: Nasopharyngeal samples from 742 healthy children less than 5 years residing in the Iganga/Mayuge Health and Demographic Surveillance Site in Eastern Uganda were processed for isolation of S. aureus. Antibiotic susceptibility testing based on minimum inhibitory concentrations (MICs) was determined by the BD PhoenixTM system. Genotyping was performed by spa and SCCmec typing. Results: The processed samples yielded 144 S. aureus isolates (one per child) therefore, the S. aureus carriage rate in children was 19.4% (144/742). Thirty one percent (45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All isolates were susceptible to rifampicin, vancomycin and linezolid. Moreover, all MRSA were susceptible to vancomycin, linezolid and clindamycin. Compared to methicillin susceptible S. aureus (MSSA) isolates (68.8%, 99/144), MRSA isolates were more resistant to non-beta-lactam antimicrobials –trimethoprim/sulfamethoxazole 73.3% (33/45) vs. 27.3% (27/99) [p<0.0001]; erythromycin 75.6% (34/45) vs. 24.2% (24/99) [p<0.0001]; chloramphenicol 60% (27/45) vs. 19.2% (19/99) [p<0.0001]; gentamicin 55.6% (25/45) vs. 25.3% (25/99) [p=0.0004]; and ciprofloxacin 35.6% (16/45) vs. 2% (2/99) [p<0.0001]. Furthermore, 42 MRSA (93.3%) were multidrug resistant (MDR) and one exhibited high-level resistance to mupirocin. Overall, 61 MSSA (61.6%) were MDR, including three mupirocin and clindamycin resistant isolates. Seven spa types were detected among MRSA, of which t037 and t064 were predominant and associated with SCCmec types I and IV, respectively. Fourteen spa types were detected in MSSA which consisted mainly of t645 and t4353. Conclusions: S. aureus carriage rate in healthy children in Eastern Uganda is high and comparable to rates for hospitalized patients in Kampala. The detection of mupirocin resistance is worrying as it could rapidly increase if mupirocin is administered in a low-income setting. S. aureus strains of spa types t064, t037 (MRSA) and t645, t4353 (MSSA) are prevalent and could be responsible for majority of staphylococcal infections in Uganda.


2019 ◽  
Author(s):  
David Kateete ◽  
Benon B Asiimwe ◽  
Raymond Mayanja ◽  
Brian Mujuni ◽  
Freddie Bwanga ◽  
...  

Abstract Background Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group, etc. This study aimed to determine the S. aureus carriage rate in Ugandan children, and track Staphylococcus strains that can cause infection in Uganda. Methods Nasopharyngeal samples (one per child) from 742 healthy children under 5 years living in Iganga/Mayuge Health & Demographic Surveillance Site in eastern Uganda were processed for isolation of S. aureus. Genotyping was performed by spa typing and pulse field gel electrophoresis. Results The processed samples yielded 144 S. aureus isolates (one per sample/child) therefore, the S. aureus carriage rate in the children was 19.4% (144/742). Further, 45 (31.3%, 45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All MRSA isolates were susceptible to vancomycin, linezolid and clindamycin however, compared to methicillin susceptible S. aureus (MSSA) isolates (68.8%, 99/144), MRSA were more resistant to non-beta-lactam antimicrobials –tetracycline (91.1%, 41/45), trimethoprim/sulfamethoxazole (73.3%, 33/45), erythromycin (75.6%, 34/99), chloramphenicol (60%, 19/99), gentamicin (55.6%, 25/45) and ciprofloxacin (35.6%, 16/45). Furthermore, an MRSA isolate was mupirocin resistant and 42 (93.3%, 42/45) were multidrug resistant (MDR); three (3%, 3/99) MSSA isolates were mupirocin and clindamycin resistant while 61 (61.6%, 61/99) were MDR. All MSSA/MRSA isolates were susceptible to rifampicin, vancomycin and linezolid but only two were pan-susceptible to the tested antibiotics. Seven spa types were detected in MRSA, of which t064 & t037 were predominant and associated with SCCmec types I & IV, respectively. Fourteen spa types were detected in MSSA, of which t645 & t4353 were predominant. Conclusions S. aureus (MSSA/MRSA) carriage rate in children in rural eastern Uganda is high and comparable to rates for hospitalized patients in Kampala city. Detection of mupirocin resistance is worrying as it could rapidly increase in a low-income setting should mupirocin be used for staphylococcal decolonization. Further, S. aureus strains of spa types t064, t037, t645 & t4353 are prevalent and could be responsible for majority of staphylococcal infections in Uganda.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
David Patrick Kateete ◽  
Benon B. Asiimwe ◽  
Raymond Mayanja ◽  
Brian Mujuni ◽  
Freddie Bwanga ◽  
...  

Abstract Background Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group and profession. This study aimed to determine the S. aureus carriage rate in children in Eastern Uganda, and identify S. aureus lineages that cause infection in Uganda. Methods Nasopharyngeal samples from 742 healthy children less than 5 years residing in the Iganga/Mayuge Health and Demographic Surveillance Site in Eastern Uganda were processed for isolation of S. aureus. Antibiotic susceptibility testing based on minimum inhibitory concentrations (MICs) was determined by the BD Phoenix™ system. Genotyping was performed by spa and SCCmec typing. Results The processed samples yielded 144 S. aureus isolates (one per child) therefore, the S. aureus carriage rate in children was 19.4% (144/742). Thirty one percent (45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All isolates were susceptible to rifampicin, vancomycin and linezolid. Moreover, all MRSA were susceptible to vancomycin, linezolid and clindamycin. Compared to methicillin susceptible S. aureus (MSSA) isolates (68.8%, 99/144), MRSA isolates were more resistant to non-beta-lactam antimicrobials –trimethoprim/sulfamethoxazole 73.3% (33/45) vs. 27.3% (27/99) [p < 0.0001]; erythromycin 75.6% (34/45) vs. 24.2% (24/99) [p < 0.0001]; chloramphenicol 60% (27/45) vs. 19.2% (19/99) [p < 0.0001]; gentamicin 55.6% (25/45) vs. 25.3% (25/99) [p = 0.0004]; and ciprofloxacin 35.6% (16/45) vs. 2% (2/99) [p < 0.0001]. Furthermore, 42 MRSA (93.3%) were multidrug resistant (MDR) and one exhibited high-level resistance to mupirocin. Overall, 61 MSSA (61.6%) were MDR, including three mupirocin and clindamycin resistant isolates. Seven spa types were detected among MRSA, of which t037 and t064 were predominant and associated with SCCmec types I and IV, respectively. Fourteen spa types were detected in MSSA which consisted mainly of t645 and t4353. Conclusions S. aureus carriage rate in healthy children in Eastern Uganda is high and comparable to rates for hospitalized patients in Kampala. The detection of mupirocin resistance is worrying as it could rapidly increase if mupirocin is administered in a low-income setting. S. aureus strains of spa types t064, t037 (MRSA) and t645, t4353 (MSSA) are prevalent and could be responsible for majority of staphylococcal infections in Uganda.


2019 ◽  
Author(s):  
David Kateete ◽  
Benon B Asiimwe ◽  
Raymond Mayanja ◽  
Brian Mujuni ◽  
Freddie Bwanga ◽  
...  

Abstract Background: Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group and profession. This study aimed to determine the S. aureus carriage rate in children in Eastern Uganda, and track Staphylococcus strains that can cause infection in Uganda. Methods: Nasopharyngeal samples from 742 healthy children under 5 years residing in the Iganga/Mayuge Health & Demographic Surveillance Site in Eastern Uganda were processed for isolation of S. aureus. Antibiotic resistance based on minimum inhibitory concentrations (MICs) was determined by the BD Phoenix™ automated identification & susceptibility testing system. Genotyping was performed by spa typing. Results: The processed samples yielded 144 S. aureus isolates (one per child) therefore, the S. aureus carriage rate in children was 19.4% (144/742). Thirty one percent (45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All MRSA isolates were susceptible to vancomycin, linezolid and clindamycin however, compared to methicillin susceptible S. aureus (MSSA) (68.8%, 99/144), MRSA isolates were more resistant to non-beta-lactam antimicrobials –tetracycline (91.1%, 41/45), trimethoprim/sulfamethoxazole (73.3%, 33/45), erythromycin (75.6%, 34/45), chloramphenicol (60%, 27/45), gentamicin (55.6%, 25/45) and ciprofloxacin (35.6%, 16/45). Furthermore, one MRSA isolate was mupirocin resistant and 42 (93.3%, 42/45) were multidrug resistant (MDR); three (3%, 3/99) MSSA isolates were mupirocin and clindamycin resistant, while 61 (61.6%, 61/99) were MDR. All MSSA/MRSA isolates were susceptible to rifampicin, vancomycin and linezolid but only three MSSA were pan-susceptible to antibiotics. Seven spa types were detected in MRSA, of which t037 & t064 were predominant and associated with SCCmec types I & IV, respectively. Fourteen spa types were detected in MSSA, of which t645 & t4353 were predominant. Conclusions: S. aureus (MSSA/MRSA) carriage rate in children in Eastern Uganda is high and comparable to rates for hospitalized patients in Kampala city. The detection of mupirocin resistance is worrying as it could rapidly increase if mupirocin is administered in a low-income setting. S. aureus strains of spa types t064, t037 (MRSA) and t645, t4353 (MSSA) are prevalent and could be responsible for majority of staphylococcal infections in Uganda.


2019 ◽  
Author(s):  
David Kateete ◽  
Benon B Asiimwe ◽  
Raymond Mayanja ◽  
Brian Mujuni ◽  
Freddie Bwanga ◽  
...  

Abstract Background: Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group and profession. This study aimed to determine the S. aureus carriage rate in children in Eastern Uganda, and track Staphylococcus strains that can cause infection in Uganda. Methods: Nasopharyngeal samples from 742 healthy children under 5 years residing in the Iganga/Mayuge Health & Demographic Surveillance Site in Eastern Uganda were processed for isolation of S. aureus. Antibiotic resistance based on minimum inhibitory concentrations (MICs) was determined by the BD Phoenix™ automated identification & susceptibility testing system. Genotyping was performed by spa typing. Results: The processed samples yielded 144 S. aureus isolates (one per child) therefore, the S. aureus carriage rate in children was 19.4% (144/742). Thirty one percent (45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All MRSA isolates were susceptible to vancomycin, linezolid and clindamycin however, compared to methicillin susceptible S. aureus (MSSA) (68.8%, 99/144), MRSA isolates were more resistant to non-beta-lactam antimicrobials –tetracycline (91.1%, 41/45), trimethoprim/sulfamethoxazole (73.3%, 33/45), erythromycin (75.6%, 34/45), chloramphenicol (60%, 27/45), gentamicin (55.6%, 25/45) and ciprofloxacin (35.6%, 16/45). Furthermore, one MRSA isolate was mupirocin resistant and 42 (93.3%, 42/45) were multidrug resistant (MDR); three (3%, 3/99) MSSA isolates were mupirocin and clindamycin resistant, while 61 (61.6%, 61/99) were MDR. All MSSA/MRSA isolates were susceptible to rifampicin, vancomycin and linezolid but only three MSSA were pan-susceptible to antibiotics. Seven spa types were detected in MRSA, of which t037 & t064 were predominant and associated with SCCmec types I & IV, respectively. Fourteen spa types were detected in MSSA, of which t645 & t4353 were predominant. Conclusions: S. aureus (MSSA/MRSA) carriage rate in children in Eastern Uganda is high and comparable to rates for hospitalized patients in Kampala city. The detection of mupirocin resistance is worrying as it could rapidly increase if mupirocin is administered in a low-income setting. S. aureus strains of spa types t064, t037 (MRSA) and t645, t4353 (MSSA) are prevalent and could be responsible for majority of staphylococcal infections in Uganda.


Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 918
Author(s):  
Saeed Khan ◽  
Bernard S. Marasa ◽  
Kidon Sung ◽  
Mohamed Nawaz

In this study, we compared pulsed-field gel electrophoretic (PFGE), multilocus sequence typing (MLST), Staphylococcal cassette chromosome mec (SCCmec), spa typing, and virulence gene profiles of 19 Panton–Valentine leucocidin (PVL)-positive, multidrug-, and methicillin-resistant clinical Staphylococcus aureus (MRSA) isolates obtained from a hospital intensive care unit in Pakistan. The isolates exhibited 10 pulsotypes, contained eight adhesin genes (bbp, clfA, clfB, cna, fnbA, fnbB, map-eap, and spa), 10 toxin genes (hla, hlb, hld, hlg, pvl, sed, see, seg, seh, and tst), and two other virulence genes (cfb, v8) that were commonly present in all isolates. The spa-typing indicated seven known spa types (t030, t064, t138, t314, t987, t1509, and t5414) and three novel spa types. MLST analysis indicated eight ST types (ST8, ST15, ST30, ST239, ST291, ST503, ST772, and ST1413). All isolates belonged to the agr group 1. Most of the isolates possessed SCCmec type III, but some isolates had it in combination with types SCCmec IV and V. The presence of multidrug-resistant MRSA isolates in Pakistan indicates poor hygienic conditions, overuse of antibiotics, and a lack of rational antibiotic therapy that have led to the evolution and development of hypervirulent MRSA clones. The study warrants development of a robust epidemiological screening program and adoption of effective measures to stop their spread in hospitals and the community.


Antibiotics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 839
Author(s):  
Yuanyuan Zhou ◽  
Xinhui Li ◽  
He Yan

China is one of the largest producers of pigs and pork in the world. However, large-scale studies on pig-associated Staphylococcus aureus in relation to healthy pigs, diseased pigs and environment are scarce. The objective of the present study was to characterize and compare S. aureus isolates from healthy pigs, diseased pigs and environment through antimicrobial susceptibility testing, multiple locus sequence typing, spa typing, and antimicrobial resistance gene screening. Results showed all isolates were susceptible to linezolid and vancomycin. However, 66.7% (104/156) isolates were multidrug-resistant by displaying resistance to three or more antibiotics and high rates of resistance to penicillin, tetracycline, clindamycin, and clarithromycin were observed. Of the 20 multilocus sequence types (STs) identified among the isolates, ST9, ST188, and ST7 were most commonly isolated from healthy pigs and environment, while ST1 was most commonly isolated from diseased pigs. In total, 17 spa types were represented among the isolates, while t4792 was most commonly isolated from diseased pigs and t899, t189 were most commonly isolated from healthy pigs and environment. In conclusion, the genotypic and epidemiology characteristics observed among the isolates suggest pigs and pork could be important players in S. aureus dissemination.


2021 ◽  
Vol 12 (1) ◽  
pp. 16-20
Author(s):  
Samiah Hamad S Al-Mijalli

Diabetic foot infections (DFIs) are a significant health issue and a common complication among patients with diabetes. To develop antibiotic therapy for these high-risk patients, the current study evaluates the scope of DFIs and identifies the causing microbes. It also measures spectrum and antibiotic susceptibility of the pathogens isolated from adults with DFIs in Saudi Arabia. To achieve the study objectives, a cross-sectional study was implemented and the baseline characteristics for 44 patients with DFIs were defined. Optimal aerobic and anaerobic microbiological techniques were utilized to culture specimens isolated from infected foot ulcers. The standard microbiological methods were employed to identify the bacterial isolates and antibiotic susceptibility testing was conducted following the procedures of the Clinical and Laboratory Standards Institute (CLSI). Results showed that 12 microorganisms were isolated from the participants’ diabetic foot ulcers. Staphylococcus Aureus was ranked first because it appeared in 29 (65.9%) cases. Streptococcus Agalactiae was ranked second and multi-microbial infections were also found. Most of the organisms were susceptible to Vancomycin, Ciprofloxacin, and Cefalexin, but they were resistant to Methicillin, Gentamicin, and Ampicillin antibiotics. Staphylococcus Aureus was most sensitive to Ciprofloxacin, while it was resistant to Methicillin. About 10% of the isolates were multidrug-resistant. The study concludes that while Vancomycin should be used empirically for Gram-positive isolates, Ciprofloxacin can be taken into consideration for most of the Gram-negatives aerobes. Based on including various microorganisms and the advent of multidrug-resistant strains, proper culture and sensitivity testing are necessary prior to the empirical therapy.


Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 395
Author(s):  
Katarina Pomorska ◽  
Vladislav Jakubu ◽  
Lucia Malisova ◽  
Marta Fridrichova ◽  
Martin Musilek ◽  
...  

Staphylococcus aureus is one of the major causes of bloodstream infections. The aim of our study was to characterize methicillin-resistant Staphylococcus aureus (MRSA) isolates from blood of patients hospitalized in the Czech Republic between 2016 and 2018. All MRSA strains were tested for antibiotic susceptibility, analyzed by spa typing and clustered using a Based Upon Repeat Pattern (BURP) algorithm. The representative isolates of the four most common spa types and representative isolates of all spa clonal complexes were further typed by multilocus sequence typing (MLST) and staphylococcal cassette chromosome mec (SCCmec) typing. The majority of MRSA strains were resistant to ciprofloxacin (94%), erythromycin (95.5%) and clindamycin (95.6%). Among the 618 strains analyzed, 52 different spa types were detected. BURP analysis divided them into six different clusters. The most common spa types were t003, t586, t014 and t002, all belonging to the CC5 (clonal complex). CC5 was the most abundant MLST CC of our study, comprising of 91.7% (n = 565) of spa-typeable isolates. Other CCs present in our study were CC398, CC22, CC8, CC45 and CC97. To our knowledge, this is the biggest nationwide study aimed at typing MRSA blood isolates from the Czech Republic.


2016 ◽  
Vol 79 (4) ◽  
pp. 682-686 ◽  
Author(s):  
LÍVIA G. BAPTISTÃO ◽  
NATHALIA C. C. SILVA ◽  
ERIKA C. R. BONSAGLIA ◽  
BRUNA F. ROSSI ◽  
IVANA G. CASTILHO ◽  
...  

ABSTRACT The hands and noses of food handlers colonized by Staphylococcus aureus are an important source of food contamination in restaurants and food processing. Several virulence factors can be carried by mobile elements in strains of S. aureus, including the immune evasion cluster (IEC). This gene cluster improves the capacity of S. aureus to evade the human immune response. Many studies have reported the transmission of strains between animals and humans, such as farm workers that have close contact with livestock. However, there are few studies on the transmission between food and food handlers. The aim of this study was to detect the IEC and the mecA gene in strains isolated from food handlers and to type these strains using the spa typing method. Thirty-five strains of S. aureus isolated from the noses and hands of food handlers in three different kitchens were analyzed for the presence of the mecA gene and IEC and by spa typing. All strains were negative for the mecA gene, and the presence of IEC was observed in 10 (28.6%) strains. Fifteen different spa types were observed, with the most frequent being t127 (42.85%) and t002 (11.42%). Strains from the two most prevalent spa types and a novel spa type were typed by multilocus sequence typing. spa types t127, t002, and t13335 were determined to be multilocus sequence types (ST) ST-30, ST-5, and ST-45, respectively. The food handlers may have been contaminated by these strains of S. aureus through food, which is suggested by the low frequency of IEC and by ST that are observed more commonly in animals.


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