Molecular Characterization of Staphylococcus aureus from Patients with Surgical Site Infections at Mulago Hospital in Kampala, Uganda
Open Access
- 20 June 2013
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (6), e66153
- https://doi.org/10.1371/journal.pone.0066153
Abstract
The prevalence of Methicillin resistant Staphylococcus aureus (MRSA) is progressively increasing globally with significant regional variation. Understanding the Staphylococcus aureus lineages is crucial in controlling nosocomial infections. Recent studies on S. aureus in Uganda have revealed an escalating burden of MRSA. However, the S. aureus genotypes circulating among patients are not known. Here, we report S. aureus lineages circulating in patients with surgical site infections (SSI) at Mulago National hospital, Kampala, Uganda. A cross-sectional study involving 314 patients with SSI at Mulago National Hospital was conducted from September 2011 to April 2012. Pus swabs from the patients’ SSI were processed using standard microbiological procedures. Methicillin sensitive Staphylococcus aureus (MSSA) and MRSA were identified using phenotypic tests and confirmed by PCR-detection of the nuc and mecA genes, respectively. SCCmec genotypes were determined among MRSA isolates using multiplex PCR. Furthermore, to determine lineages, spa sequence based-genotyping was performed on all S. aureus isolates. Of the 314 patients with SSI, S. aureus accounted for 20.4% (64/314), of which 37.5% (24/64) were MRSA. The predominant SCCmec types were type V (33.3%, 8/24) and type I (16.7%, 4/24). The predominant spa lineages were t645 (17.2%, 11/64) and t4353 (15.6%, 10/64), and these were found to be clonally circulating in all the surgical wards. On the other hand, lineages t064, t355, and t4609 were confined to the obstetrics and gynecology wards. A new spa type (t10277) was identified from MSSA isolate. On multivariate logistic regression analysis, cancer and inducible clindamycin resistance remained as independent predictors of MRSA-SSI. SCCmec types I and V are the most prevalent MRSA mecA types from the patients’ SSI. The predominant spa lineages (t645 and t4353) are clonally circulating in all the surgical wards, calling for strengthening of infection control practices at Mulago National Hospital.Keywords
This publication has 34 references indexed in Scilit:
- High prevalence of methicillin resistant Staphylococcus aureus in the surgical units of Mulago hospital in Kampala, UgandaBMC Research Notes, 2011
- Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern TanzaniaBMC Surgery, 2011
- Antibiotic resistance and molecular epidemiology of Staphylococcus aureus in NigeriaBMC Microbiology, 2011
- Identification of Staphylococcus aureus: DNase and Mannitol salt agar improve the efficiency of the tube coagulase testAnnals of Clinical Microbiology and Antimicrobials, 2010
- Distribution of Staphylococcal Cassette Chromosome mec Types and Correlation with Comorbidity and Infection Type in Patients with MRSA BacteremiaPLOS ONE, 2010
- Three months study of orthopaedic surgical site infections in an Egyptian University hospitalInternational Journal of Infection Control, 2010
- spa Typing of Staphylococcus aureus as a Frontline Tool in Epidemiological TypingJournal of Clinical Microbiology, 2008
- Assignment of Staphylococcus Isolates to Groups by spa Typing, SmaI Macrorestriction Analysis, and Multilocus Sequence TypingJournal of Clinical Microbiology, 2006
- Typing of Methicillin-Resistant Staphylococcus aureus in a University Hospital Setting by Using Novel Software for spa Repeat Determination and Database ManagementJournal of Clinical Microbiology, 2003
- Comparison of Mortality Associated with Methicillin‐Resistant and Methicillin‐SusceptibleStaphylococcus aureusBacteremia: A Meta‐analysisClinical Infectious Diseases, 2003