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Journal of Clinical Microbiology, September 2009, p. 2975-2980, Vol. 47, No. 9
0095-1137/09/$08.00+0 doi:10.1128/JCM.00648-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
Emergence of a Community-Associated Methicillin-Resistant Staphylococcus aureus Strain with a Unique Resistance Profile in Southwest Nigeria
B. Ghebremedhin,1*
M. O. Olugbosi,2
A. M. Raji,2
F. Layer,1,
R. A. Bakare,2
B. König,1 and
W. König1
Otto-von-Guericke-University Clinic, Medical Microbiology, Magdeburg, Germany,1 University College Hospital, Medical Microbiology and Parasitology, Ibadan, Nigeria2
Received 31 March 2009/ Returned for modification 3 June 2009/ Accepted 25 June 2009
Phenotypic, genotypic, and toxin gene analyses have not yet been done all in one for the Nigerian Staphylococcus aureus population. This study provides a comprehensive overview of the molecular epidemiology and genetic diversity of S. aureus strains at the largest university clinic in Ibadan, Nigeria. From 1,300 patients' clinical samples collected at the University Teaching Hospital in Ibadan, Nigeria, during a 1-year-surveillance in 2007, 346 nonduplicate S. aureus isolates were obtained. All isolates underwent antibiotic susceptibility testing, toxin gene analysis, multilocus sequence typing, agr group typing, and spa typing. For methicillin (meticillin)-resistant S. aureus (MRSA), staphylococcal cassette chromosome mec (SCCmec) typing was also performed. Of the 346 isolates, 20.23% were methicillin resistant. Thirty-three patients' isolates (47.15%) fulfilled the definition criteria for community-associated MRSA (CA-MRSA) according to a review of the medical charts. The majority of MRSA strains analyzed were isolated from surgical or pediatric patients. The commonest types of MRSA infection identified were surgical-site infections (>70%), whereas those for CA-MRSA were conjunctivitis and otitis (19 patients [57.6%]) and accidental skin and subcutaneous tissue infections (14 patients [42.4%]). The methicillin-susceptible S. aureus strains (ST1, ST5, ST15, ST7, ST8, ST25, ST30, ST72, ST80, ST121, and ST508) were heterogeneous by phenotypic and genotypic analyses. The first report of a Panton-Valentine leukocidin-positive ST88 strain (agr III, SCCmec IV) in Nigeria, as well as genetic analyses of this strain, is presented in this study. The ST88 strain was resistant to trimethoprim-sulfamethoxazole as well as to penicillin and oxacillin. CA-MRSA infections are increasing rapidly among young patients with ophthalmologic and auricular infections. Urban regions with populations of lower socioeconomic status and evidence of overcrowding appear to be at high risk for the emergence of this clone.
* Corresponding author. Mailing address: Otto-von-Guericke-University Clinic, Medical Microbiology, Magdeburg, Germany. Phone: 00493916713328. Fax: 00493916717802. E-mail: beniam.ghebremedhin{at}med.ovgu.de
Published ahead of print on 1 July 2009.
Present address: Robert Koch-Institute, Wernigerode, Germany.
Journal of Clinical Microbiology, September 2009, p. 2975-2980, Vol. 47, No. 9
0095-1137/09/$08.00+0 doi:10.1128/JCM.00648-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
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