Community-Associated Staphylococcus aureus from Sub-Saharan Africa and Germany: A Cross-Sectional Geographic Correlation Study

Abstract

Clonal clusters and gene repertoires of Staphylococcus aureus are essential to understand disease and are well characterized in industrialized countries but poorly analysed in developing regions. The objective of this study was to compare the molecular-epidemiologic profiles of S. aureus isolates from Sub-Saharan Africa and Germany. S. aureus isolates from 600 staphylococcal carriers and 600 patients with community-associated staphylococcal disease were characterized by DNA hybridization, clonal complex (CC) attribution, and principal component (PCA)-based gene repertoire analysis. 73% of all CCs identified representing 77% of the isolates contained in these CCs were predominant in either African or German region. Significant differences between African versus German isolates were found for alleles encoding the accessory gene regulator type, enterotoxins, the Panton-Valentine leukocidin, immune evasion gene cluster, and adhesins. PCA in conjunction with silhouette analysis distinguished nine separable PCA clusters, with five clusters primarily comprising of African and two clusters of German isolates. Significant differences between S. aureus lineages in Africa and Germany may be a clue to explain the apparent difference in disease between tropical/(so-called) developing and temperate/industrialized regions. In low-resource countries further clinical-epidemiologic research is warranted not only for neglected tropical diseases but also for major bacterial infections.

Molecular Characterization of Community Acquired Staphylococcus aureus Bacteremia in Young Children in Southern Mozambique, 2001–2009

“…Although the sample size was small, the high case fatality rate among children infected with CC45 and CC8 compared to other CCs, may suggest possible differences on the degree of pathogenicity among CCs. The high prevalence of CC8 and CC15 in our study is consistent with findings from the African German multi-centric study conducted from 2010 to 2013 in Africa and Germany on infection biology and epidemiology of S. aureus (http://www.african-german-staph.net) (Ruffing et al, 2017). Similarly, these CCs have been consistently reported in patients with bacteremia in Germany (Rieg et al, 2013), Sweden (Rasmussen et al, 2013) and from different infection sites in Nigeria, Northern Africa (Shittu et al, 2012).…”

Prevalence, antimicrobial susceptibility and genotypic characteristics of Staphylococcus aureus in Tanzania: a systematic review

“…Nurjadi et al 2014 whilst researching on trimethoprim resistance genes in S. aureus isolated from different countries determined that 100% of the Tanzanian isolated in the study which were phenotypically trimethoprim resistant in fact harboured a trimethoprim conferring resistant gene (52). This emphasises the need for research efforts to be directed towards researching a wider range of resistance causing genes in S. aureus to get comprehensive resistance profile data.Most pvl positive MSSA clones associate with skin infections identified in this review belonged to ST152 which concurs with the findings from other African based studies(53).…”

Presence of egc-positive major clones ST 45, 30 and 22 among methicillin-resistant and methicillin-susceptible oral Staphylococcus aureus strains

“…Our MSSA corresponded to major clones widespread in Poland and other European countries 19 , 49 , 51 – 54 . In contrast, different predominant clonal complexes were reported in Africa and Asia, indicating geographical variation 53 , 55 , 56 .…”