Local Epidemiology of Nosocomial Staphylococcus aureus Infection in a Nigerian University Teaching Hospital

Abstract

Population-based studies of Staphylococcus aureus contribute to understanding the epidemiology of S. aureus infection. We enrolled surgical inpatients admitted to an African tertiary-care hospital in order to prospectively analyze the nosocomial impact of S. aureus. Data collection included an active sampling of the anterior nares and infectious foci within 48 h after admission and subsequently when clinically indicated. All S. aureus isolates were spa and agr genotyped. Possession of Panton-Valentine leukocidin (PVL) and other toxin genes was determined. We analyzed antibiotic susceptibility profiles by VITEK 2 systems and verified methicillin-resistant S. aureus (MRSA) by mecA/C PCR. Among 325 patients, 15.4% carried methicillin-susceptible S. aureus (MSSA) at admission, while 3.7% carried MRSA. The incidence densities of nosocomial infections due to MSSA and MRSA were 35.4 and 6.2 infections per 10,000 patient-days, respectively. Among all 47 nosocomial infections, skin and soft-tissue (40.4%) and bones or joints’ (25.5%) infections predominated. Six (12.7%) infection-related S. aureus isolates harbored PVL genes including two (4.2%) MRSA: overall, seventeen (36.2%) isolates carried pyrogenic toxin superantigens or other toxin genes. This study illustrates the considerable nosocomial impact of S. aureus in a Nigerian University hospital. Furthermore, they indicate a need for effective approaches to curtail nosocomial acquisition of multidrug-resistant S. aureus.

The burden of hospital-acquired infections (HAI) in sub-Saharan Africa: a systematic review and meta-analysis

“…Of 4338 citations identified, 41 prevalence studies, 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 which included 6821 patients, met our eligibility criteria ( Fig. 1 ).…”

“…1 ). The included studies were selected from all four subregions of SSA: fifteen studies from West Africa, 17 , 21 , 22 , 25 , 27 , 28 , 32 , 36 , 37 , 43 , 46 , 47 , 49 , 50 , 55 twelve from Southern Africa, 16 , 19 , 23 , 29 , 30 , 33 , 38 , 40 , 45 , 52 , 53 , 54 eleven from East Africa, 20 , 24 , 26 , 31 , 34 , 35 , 41 , 42 , 44 , 48 , 51 and three from Central Africa 18 , 39 , 56 ( Fig. 2 ).…”

“…38 , 53 Use of antibiotics, 38 , 48 blood transfusion 48 and age less than 12 years 48 were also reported. Associated risk factors for HAI in adults were indwelling device, 18 , 20 , 24 , 26 , 29 , 42 , 44 , 55 , 56 prolonged hospital stay, 22 , 24 , 26 , 34 , 42 , 47 surgery, 29 , 38 , 42 , 46 , 47 , 55 , 56 antibiotic use, 47 , 55 , 56 pre-existing medical conditions, 22 , 26 , 27 , 29 , 43 blood transfusion 34 , 46 and male sex. 21 …”

Staphylococcus aureus associated with surgical site infections in Western Kenya reveals genomic hotspots for pathogen evolution

“…However, based on the rather small number of genomic analyses carried out to date, fewer Staphylococcal subtypes/sequence types (STs) have been reported for sub-Saharan isolates. Nevertheless, ST8, ST5, and ST239 [ 14 ] have all previously been associated with hospital and community infections in the region [ 15 16 ], and ST152 and ST121 have been associated with community-acquired infections [ 16 20 ]. Indeed, the prevalence of ST152 has been reported to be high in hospital settings in Kenya [ 10 21 22 ], indicating that this clone may be a regionally important.…”