Nasopharyngeal Carriage and Antimicrobial Susceptibility Profile of Staphylococcus aureus among Children under Five Years in Accra

Abstract

This cross-sectional study investigated the S. aureus and methicillin-resistant S. aureus (MRSA) nasopharyngeal carriage epidemiology in Accra approximately five years post-pneumococcal conjugate vaccine introduction in the country. Archived nasopharyngeal swabs collected from 410 children aged under five years old were bacteriologically cultured. The resultant S. aureus isolates were subjected to antimicrobial susceptibility testing and screening for carriage of the mecA and LukF-PV (pvl) genes, following standard procedures. The data obtained were analyzed with Statistical Products and Services Solutions (SPSS) using descriptive statistics and Chi square tests of associations. The isolated bacteria decreased across coagulase-negative Staphylococci (47.3%, n = 194), S. aureus (23.2%, n = 95), Diphtheroids (5.4%, n = 22), Micrococcus species (3.7%, n = 15), Klebsiella pneumoniae (3.2%, n = 13), Moraxella species and Citrobacter species (1.5% each, n = 6), Escherichia coli, Enterobacter species, and Pseudomonas species (0.9% each, n = 2). The MRSA carriage prevalence was 0.49% (n = 2). Individuals aged 37–48 months recorded the highest proportion of S. aureus carriage (32.6%, 31/95). Resistance of S. aureus to the antibiotics tested were penicillin G (97.9%, n = 93), amoxiclav (20%, n = 19), tetracycline (18.9%, n = 18), erythromycin (5.3%, n = 5), ciprofloxacin (2.1%, n = 2), gentamicin (1.1%, n = 1), cotrimoxazole, clindamycin, linezolid, and teicoplanin (0% each). No inducible clindamycin resistance was observed for the erythromycin-resistant isolates. Three (3.2%) of the isolates were multidrug resistant, of which 66.7% (2/3) were MRSA. The pvl gene was associated with 59.14% (55/93) of the methicillin-sensitive S. aureus (MSSA) isolates, but was not detected among any of the MRSA isolates.

Methicillin-Resistant Staphylococcus aureus (MRSA) Infection of Diabetic Foot Ulcers at a Tertiary Care Hospital in Accra, Ghana

“…The highest proportion of S. aureus resistance was recorded against penicillin (100%). Previous studies in the country have also reported similar rates for the organism [ 30 , 53 , 54 , 56 , 57 , 58 ], and this may be due to the wide usage of the antibiotic. These studies additionally recorded similar antimicrobial resistance rates for the other antimicrobials investigated [ 30 , 53 , 54 , 56 , 57 , 58 ].…”

“…Previous studies in the country have also reported similar rates for the organism [ 30 , 53 , 54 , 56 , 57 , 58 ], and this may be due to the wide usage of the antibiotic. These studies additionally recorded similar antimicrobial resistance rates for the other antimicrobials investigated [ 30 , 53 , 54 , 56 , 57 , 58 ]. Of particular interest is the high resistance displayed against cotrimoxazole in the current study, given its usage in prophylaxis.…”

“…Moreover, that MRSA prevalence was 6% and accounted for 31.6% of these S. aureus isolates is a cause for concern, given the high clinical significance of the pathogen. It is noted, though, that this prevalence is below the 15% to 30% prevalence usually attributed to MRSA in DFUs [ 52 ] and may be a reflection of the low MRSA prevalence in the country [ 30 , 53 , 54 , 55 , 56 , 57 , 58 ].…”

Alarming Levels of Multidrug Resistance in Aerobic Gram-Negative Bacilli Isolated from the Nasopharynx of Healthy Under-Five Children in Accra, Ghana

“…This was a cross-sectional study involving retrospective analysis of frozen swab samples stored at −80 °C in skim milk tryptone glucose glycerol broth (STGG). These samples were collected as part of a previous study conducted in 2016 which examined carriage rates of S. pneumoniae and S. aureus [ 16 , 17 ].…”

“…In previous studies, S. pneumoniae [ 16 ] and S . aureus [ 17 ] were isolated, antimicrobial susceptibility testing and serotyping were performed, and the data were analysed using standard techniques. For the purpose of this study, GNB were isolated, and antimicrobial susceptibility testing was performed.…”