Methicillin-resistant Staphylococcus aureus (MRSA) in East Africa: red alert or red herring?

Abstract

Background Methicillin-resistant Staphylococcus aureus (MRSA) is associated with significant morbidity and mortality and has resultant important economic and societal costs underscoring the need for accurate surveillance. In recent years, prevalence rates reported in East Africa have been inconsistent, sparking controversy and raising concern. Methods We described antimicrobial susceptibility patterns of Staphylococcus aureus isolates cultured from patients within the Internal Medicine department of the largest public healthcare facility in East and Central Africa- the Kenyatta National Hospital (KNH) in Nairobi, Kenya. Routine antimicrobial susceptibility data from non-duplicate Staphylococcus aureus isolates cultured between the years 2014–2016 from the medical wards in KNH were reviewed. Results Antimicrobial susceptibility data from a total of 187 Staphylococcus aureus isolates revealed an overall MRSA prevalence of 53.4%. Isolates remained highly susceptible to linezolid, tigecycline, teicoplanin and vancomycin. Conclusions The prevalence of MRSA was found to be much higher than that reported in private tertiary facilities in the same region. Careful interrogation of antimicrobial susceptibility results is important to uproot any red herrings and reserve genuine cause for alarm, as this has a critical bearing on health and economic outcomes for a population. Electronic supplementary material The online version of this article (10.1186/s12879-019-4245-3) contains supplementary material, which is available to authorized users.

Species and drug susceptibility profiles of staphylococci isolated from healthy children in Eastern Uganda

“…occurrence of animal-associated CoPS in human samples, which could yield false-positive results on coagulase testing and overestimation of S. aureus/MRSA rates [30]. Around 5% of the children in this study were colonized by two or three Staphylococcus species, fewer than reports by investigators from Europe (i.e.…”

“…The Automated system we used i.e. the Phoenix AST/ID Expert System, is more accurate than the manual methods at identifying Gram-positive bacteria, as well as AMR testing [30]. However, in the developing countries, manual methods are the mainstay for identification of staphylococci, and in most cases the tube coagulase test is the confirmatory test for identification of S. aureus [5].…”

Antibiotic Susceptibility Pattern of Methicillin Sensitive and Resistant Staphylococcus aureus from Clinical Isolates in a Tertiary Care Hospital at Mathura, Western Uttar Pradesh

“…Data on the prevalence of MRSA is not uniform. Literature has documented a significant variation in the prevalence rate from different parts of India and between countries [1][2][3][4][5][6][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] . Studies from India report MRSA prevalence ranging from 6.9% to 87% 9 .…”

“…In the early 1960s, Methicillin Resistant S.aureus (MRSA) emerged as a potential pathogen causing nosocomial colonization, several outbreaks and difficult-to-treat infections like bacteremia, infective endocarditis, osteoarticular and pleuropulmonary infections. They also causes device related infections like central line associated blood stream infections, ventilator associated pneumonia and catheter associated urinary tract infections [1][2][3][4][5] . It always remains a challenge for physicians to treat and control MRSA infections.…”

Prevalence and antimicrobial susceptibility pattern of Staphylococcus Aureus isolated from clinical specimens at the Mater Hospital Nairobi, Kenya.

“…[4,11] In Africa, MRSA prevalence intra-country and intercountry has been reported to be heterogeneous. In Kenya the data has been variable and inconsistent due to lack of effective and systematic routine surveillance systems [15].…”