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Cited by 108Antimicrobial Resistance in StaphylococcusAntibiotic Use and ResistanceAntibiotic Resistance in Bacteria

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Molecular Epidemiology and Antimicrobial Susceptibility of Clinical Staphylococcus aureus from Healthcare Institutions in Ghana

Open access
Egyir, Beverly, Guardabassi, Luca, Sørum, Marit, Nielsen, Søren Saxmose, Kolekang, Augusta, Frimpong, Enoch, Addo, Kennedy Kwasi, Newman, Mercy Jemima, Larsen, Anders Rhod·2014·PLoS ONE
DOI 10.1371/journal.pone.0089716PMC PMC3934920
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Abstract

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.

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Figure 1 Origins of the 308 clinical Staphylococcus aureus collected from six hospitals in Ghana, 2010–2012. †Referral Hospitals. ‡Secondary Hospitals. §Primary Hospitals. 1SSTI: Skin and Soft Tissue Infections. 2Other: (Urinary Tract Infection (n = 9); Unknown Infections (n = 14)).
Figure 1 Origins of the 308 clinical Staphylococcus aureus collected from six hospitals in Ghana, 2010–2012. †Referral Hospitals. ‡Secondary Hospitals. §Primary Hospitals. 1SSTI: Skin and Soft Tissue Infections. 2Other: (Urinary Tract Infection (n = 9); Unknown Infections (n = 14)).CC BY · PubMed Central
Figure 2 Minimum spanning tree of 308 clinical Staphylococcus aureus isolates from healthcare institutions in Ghana. Nodes indicate spa types and their size shows the relative number of isolates for each spa type. Numbers of frequent (three or more) spa types have been shown. Every colour represents a distinct clonal complex.
Figure 2 Minimum spanning tree of 308 clinical Staphylococcus aureus isolates from healthcare institutions in Ghana. Nodes indicate spa types and their size shows the relative number of isolates for each spa type. Numbers of frequent (three or more) spa types have been shown. Every colour represents a distinct clonal complex.CC BY · PubMed Central

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Metadata

Authors
Egyir, B., Guardabassi, L., Sørum, M., Nielsen, S. S., Kolekang, A., Frimpong, E., Addo, K. K., Newman, M. J., & Larsen, A. R.
Affiliations
  • Statens Serum Institut (DK)
  • University of Copenhagen (DK)
  • Kwame Nkrumah University of Science and Technology (GH)
  • Noguchi Memorial Institute for Medical Research (GH)
  • University of Ghana (GH)
Corresponding author
Egyir, Beverly
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2014-02-25
Volume
9
Issue
2
Pages
e89716
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0089716
PMC
PMC3934920
OpenAlex
W2071056263
Cited by
108
References
38
Citations by year
2026: 5 · 2025: 5 · 2024: 4 · 2023: 4 · 2022: 9 · 2021: 8 · 2020: 10 · 2019: 10 · 2018: 11 · 2017: 16 · 2016: 9 · 2015: 11 · 2014: 6
FWCI
9.84
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion, cc-by)
  • Greater South Information System
Funders
Danish International Development Agency
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
  • Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
  • Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
Keywords
Staphylococcus aureus, antimicrobial resistance, methicillin-resistant Staphylococcus aureus, spa typing, clonal complexes, Panton-Valentine leukocidin, SCCmec typing, multilocus sequence typing, mecA gene, penicillin resistance, tetracycline resistance, erythromycin resistance, nosocomial infections, Ghana
MeSH terms
Ghana, Humans, Microbial Sensitivity Tests, Prospective Studies, Staphylococcal Skin Infections, Staphylococcus aureus, Molecular Epidemiology, Methicillin-Resistant Staphylococcus aureus

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