Cited by 41Antimicrobial Resistance in StaphylococcusAntibiotic Use and ResistanceAntibiotic Resistance in Bacteria

Antibiotic resistance and clonal diversity of invasive Staphylococcus aureus in the rural Ashanti Region, Ghana

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Dekker, Denise, Wolters, Manuel, Mertens, Eva, Boahen, Kennedy Gyau, Krumkamp, Ralf, Eibach, Daniel, Schwarz, Norbert G., Adu-Sarkodie, Yaw +5 more·2016·BMC Infectious Diseases

Abstract

BACKGROUND: Staphylococcus aureus is among the most common pathogens isolated from blood cultures in Ghana; yet the epidemiology of blood infections in rural settings is poorly described. This study aims to investigate antimicrobial susceptibility and clonal diversity of S. aureus causing bloodstream infections in two hospitals in the Ashanti Region, Ghana. METHODS: Blood cultures were performed for all febrile patients (≥37.5 °C) on hospital admission. Antibiotic susceptibility testing for S. aureus isolates was carried out by the VITEK 2 system. Multiplex polymerase chain reaction (PCR) was used to detect S. aureus-specific nuc gene, Panton-Valentine leukocidin (PVL), and methicillin-resistant S. aureus (MRSA)-specific mecA and mecC genes. The population structure of S. aureus was assessed by spa typing. RESULTS: In total, 9,834 blood samples were cultured, out of which 0.6% (n = 56) were positive for S. aureus. Multidrug resistance (MDR) was detected in 35.7% (n = 20) of the S. aureus strains, of which one was a MRSA. The highest rate of antibiotic resistance was seen for commonly available antibiotics, including penicillin (n = 55; 98.2%), tetracycline (n = 32; 57.1%) and trimethoprim/sulfamethoxazole (n = 26; 46.4%). Of all S. aureus strains, 75.0% (n = 42) carried the PVL-encoding genes. We found 25 different spa types with t355 (n = 11; 19.6%), t314 (n = 8; 14.3%), t084 (n = 8; 14.3%) and t311 (n = 5; 8.9%) being predominant. CONCLUSION: The study exhibited an alarmingly large level of antibiotic resistance to locally available antibiotics. The frequency of genetically diverse and PVL-positive methicillin-sensitive S. aureus (MSSA) was high and could represent a reservoir for the emergence of virulent PVL-positive MRSA clones.

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Authors
Dekker, D., Wolters, M., Mertens, E., Boahen, K. G., Krumkamp, R., Eibach, D., Schwarz, N. G., Adu-Sarkodie, Y., Rohde, H., Christner, M., Marks, F., Sarpong, N., & May, J.
Affiliations
  • German Center for Infection Research (DE)
  • University Medical Center Hamburg-Eppendorf (DE)
  • Kumasi Centre for Collaborative Research in Tropical Medicine (GH)
  • Bernhard Nocht Institute for Tropical Medicine (DE)
  • International Vaccine Institute (KR)
Corresponding author
Dekker, Denise
Venue
BMC Infectious Diseases
Published
2016-11-29
Volume
16
Issue
1
Pages
720-720
ISSN
1471-2334 (ISSN-L)
OpenAlex
W2558237231
Cited by
40
References
26
Citations by year
2026: 2 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 8 · 2021: 4 · 2020: 4 · 2019: 5 · 2018: 3 · 2017: 1
FWCI
2.77
Type
journal article
Language
en
Open access
Locations
  • BMC Infectious Diseases (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • Apollo (cc-by)
  • Greater South Information System
Funders
  • UBS Optimus Foundation
  • Bill and Melinda Gates Foundation (5785)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
Keywords
Staphylococcus aureus, antibiotic resistance, multidrug resistance, bloodstream infection, clonal diversity, spa typing, Panton-Valentine leukocidin, methicillin-resistant Staphylococcus aureus, methicillin-susceptible Staphylococcus aureus, mecA gene, mecC, penicillin resistance, tetracycline resistance, trimethoprim-sulfamethoxazole resistance, rural hospitals, Ashanti Region, Ghana
MeSH terms
Adolescent, Anti-Bacterial Agents, Bacterial Proteins, Bacterial Toxins, Child, Child, Preschool, Exotoxins, Female, Ghana, Hospitals, Humans, Infant, Infant, Newborn, Leukocidins, Male, Microbial Sensitivity Tests, Rural Population, Staphylococcal Infections, Staphylococcus aureus, Genetic Variation, Bacteremia, Drug Resistance, Multiple, Bacterial, Penicillin-Binding Proteins, Methicillin-Resistant Staphylococcus aureus, Multiplex Polymerase Chain Reaction

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