Epidemiology of methicillin-resistant Staphylococcus aureus lineages in five major African towns: emergence and spread of atypical clones

Abstract

The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Africa is poorly documented. From January 2007 to March 2008, we collected 86 MRSA isolates from five African towns, one each in Cameroon, Madagascar, Morocco, Niger and Senegal. Although one or two major clones, defined by the sequence type and staphylococcal cassette chromosome mec type, predominated at each site, genetic diversity (ten clones) was relatively limited in view of the large geographical area studied. Most of the isolates (n = 76, 88%) belonged to three major clones, namely ST239/241-III, a well-known pandemic clone (n = 34, 40%), ST88-IV (n = 24, 28%) and ST5-IV (n = 18, 21%). The latter two clones have only been sporadically described in other parts of the world. The spread of community-associated MRSA carrying the Panton-Valentine leukocidin genes is a cause for concern, especially in Dakar and possibly throughout Africa.

Predominance of methicillin resistant Staphylococcus aureus -ST88 and new ST1797 causing wound infection and abscesses

“…All four PVL-positive strains belonged to CC88 in this study. One of these genotypes, ST88 (spa t186), was identified in another study from Africa [6].…”

“…Spa typing has also been validated for long-term nationwide surveillance studies [5]. In the few studies which have been conducted to characterize ST and spa types in Africa, the majority of MRSA isolates has been assigned to ST8 and ST88 [6,7]. In a multicentre study ST88 was detected in five major African towns in Morocco, Senegal, Niger, and Cameroon [6].…”

“…In South Africa, 67% of MRSA isolates were assigned to ST 8 [7]. Other STs reported in Africa include ST239, ST30, ST72, ST1289 and ST243 [6][7][8][9].…”

“…In the few studies which have been conducted to characterize ST and spa types in Africa, the majority of MRSA isolates has been assigned to ST8 and ST88 [6,7]. In a multicentre study ST88 was detected in five major African towns in Morocco, Senegal, Niger, and Cameroon [6]. ST 88 has recently been reported in Nigeria [8], as well as in children from Western Africa who had undergone surgery in Switzerland and who had later been hospitalized in their home countries [9].…”

Pulsed Field Gel Electrophoresis in Molecular Typing and Epidemiological Detection of Methicillin Resistant Staphylococcus aureus (MRSA)

“…This species nevertheless represents a serious public health burden, particularly the clones which are resistant to methicillin and other classes of antibiotics; the emergence of penicillin-methicillin-, and recently high-level vancomycinresistant strains emphasize the importance and urgency of such rational prescribing policy for the treatment of MRSA infections (Appelbaum, 2007;Goldstein 2007). Multiple studies have shown clonal spreads of epidemic MRSA strains within hospitals, between hospitals within a country (Breurec et al, 2011;Nübel et al, 2010), and also between countries and continents (Breurec et al, 2011;Deurenberg et al, 2009;Diekema et al 2001). There are only a limited number of nosocomial MRSA clones spread worldwide (the Iberian (Enright et al, 2002;Oliveira et al, 2001).…”