Molecular Epidemiology and Antimicrobial Susceptibility of Clinical Staphylococcus aureus from Healthcare Institutions in Ghana
Molecular Epidemiology and Antimicrobial Susceptibility of Clinical Staphylococcus aureus from Healthcare Institutions in Ghana
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DOI：
10.1371/journal.pone.0089716
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发表时间：
2014-02-25
期刊：
影响因子：
3.7
通讯作者：
Larsen, Anders Rhod
中科院分区：
文献类型：
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作者：
Egyir, Beverly;Guardabassi, Luca;Larsen, Anders Rhod
本研究的目的是确定加纳临床金黄色葡萄球菌分离株的抗菌药物敏感性模式和克隆多样性。共308个S。对来自加纳北方、中部和南部的6个医疗机构的金黄色葡萄球菌分离株进行PCR分型、SPA分型和PantonValentineleukocin（PVL）基因的PCR检测。耐甲氧西林表皮葡萄金黄色葡萄球菌（MRSA）的mecA基因PCR检测证实，并进一步进行SCCmec和多位点序列分型（MLST）。除青霉素（97%）、四环素（42%）和红霉素（6%）外，所有受试药物的耐药率均低于5%。共发现91个温泉类型，其中t355（ST 152，19%），t084（ST 15，12%）和t314（ST 121，6%）是最常见的类型。根据spa和MLST类型之间的既定关联，将分离株分配至16个克隆复合体（CC）：CC152（n = 78）、CC15（n = 57）、CC121（n = 39）、CC8（n = 36）、CC5（n = 33）、CC1（n = 29）、CC45（n = 9）、CC88（n = 8）、CC30（n = 4）、CC9（n = 3）、CC25（n = 2）、CC97（n = 2）、CC20（n = 2）、CC707（n = 2）、CC7（n = 3）和CC522（n = 1）。大多数分离株（60%）为PVL阳性，尤其是属于ST 152、ST 121、ST 5、ST 15、ST 1、ST 8和ST 88的分离株。9株（3%）分离株为MRSA，属于7个不同克隆：ST 88-IV（n = 2）、ST 250-I（n = 2）、ST 8-IV（n = 1）、ST 72-V（n = 1）、ST 789-IV（n = 1）、ST 2021-V（n = 1）和ST 239-III（n = 1）。研究证实PVL阳性的S.与发达国家和其他非洲国家相比，加纳的耐药性普遍较低，MRSA谱系多样性较高。在大多数加纳临床微生物学实验室没有常规MRSA鉴定的情况下检测到已知的大流行性MRSA克隆，这要求进行能力建设，以加强监测和防止这些克隆的传播。
The objective of this study was to determine the antimicrobial susceptibility patterns and clonal diversity of clinical Staphylococcus aureus isolates from Ghana. A total of 308 S. aureus isolates from six healthcare institutions located across Northern, Central and Southern Ghana were characterized by antibiotyping, spa typing and PCR detection of Panton Valentine leukocin (PVL) genes. Methicillin-resistant S. aureus (MRSA) were confirmed by PCR detection of mecA gene and further characterized by SCCmec and multi-locus sequence typing (MLST). The prevalence of antimicrobial resistance was below 5% for all agents tested except for penicillin (97%), tetracycline (42%) and erythromycin (6%). Ninety-one spa types were found, with t355 (ST152, 19%), t084 (ST15, 12%) and t314 (ST121, 6%) being the most frequent types. Based on established associations between spa and MLST types, isolates were assigned to 16 clonal complexes (CCs): CC152 (n = 78), CC15 (n = 57), CC121 (n = 39), CC8 (n = 36), CC5 (n = 33), CC1 (n = 29), CC45 (n = 9), CC88 (n = 8), CC30 (n = 4), CC9 (n = 3), CC25 (n = 2), CC97 (n = 2) CC20 (n = 2), CC707 (n = 2), CC7 (n = 3) and CC522 (n = 1). Most isolates (60%) were PVL-positive, especially those belonging to ST152, ST121, ST5, ST15, ST1, ST8, and ST88. Nine (3%) isolates were MRSA belonging to seven distinct clones: ST88-IV (n = 2), ST250-I (n = 2), ST8-IV (n = 1), ST72-V (n = 1), ST789-IV (n = 1), ST2021-V (n = 1), and ST239-III (n = 1). The study confirmed a high frequency of PVL-positive S. aureus in Africa, low prevalence of antimicrobial resistance and high diversity of MRSA lineages in Ghana compared to developed countries and other African countries. The detection of known pandemic MRSA clones in the absence of routine MRSA identification in most Ghanaian clinical microbiology laboratories calls for capacity building to strengthen surveillance and prevent spread of these clones.