Antimicrobial Susceptibility Patterns of Staphylococcus aureus and Characterization of MRSA in Southwestern Nigeria

  • Thu, 9/4/08 - 11:52am
  • 0 Comments
  • 4587 reads
Author(s): 
Adebayo Shittu, BSc, MSc, PhD;1,2 Johnson Lin, BSc, MSc, PhD;2 Deboye Kolawole, BSc, MSc, PhD1

Staphylococcus aureus is an important pathogen in human infections and is implicated in a wide variety of infections, from mild skin infections to more serious and invasive infections, including septicemia, pneumonia, endocarditis, deep-seated abscesses, and toxinoses including food poisoning and toxic shock syndrome.1,2 The discovery of antimicrobial agents has been a critical element of the therapeutic armamentarium of modern medicine, but the treatment of infections caused by S aureus is still a challenge for clinicians.3,4 Numerous studies have indicated that S aureus is among the most frequently encountered microorganisms in microbiology laboratories in Nigeria.5–13 However, data on the antibiotic susceptibility patterns of this pathogen in Southwestern Nigeria are inadequate, and in most cases, isolates are screened against commonly available antibiotics. In addition, information on the prevalence and characterization of methicillin-resistant S aureus (MRSA) in this region is insufficient despite the established fact that MRSA is a significant health problem worldwide. The ability to characterize S aureus and monitor antimicrobial susceptibility patterns is important for clinicians selecting empiric antimicrobial therapy, rational formulation of public healthcare policies, and providing useful information on the global surveillance of this pathogen. The authors report on the antibiotic susceptibility of S aureus isolates obtained from various clinical samples and the characterization of MRSA in Southwestern Nigeria.

References: 

1. Tenover FC, Gaynes RP. The epidemiology of Staphylococcus infections. In: Fischetti VA, Novick RP, Ferretti JJ, Portnoy DA, Rood JL, eds. Gram-Positive Pathogens. Washington, DC: American Society for Microbiology, 2000:414–421.
2. Holmes A, Ganner M, McGuane S, Pitt TL, Cookson BD, Kearns AM. Staphylococcus aureus isolates carrying Panton-Valentine leucocidin genes in England and Wales: frequency, characterization, and association with clinical disease. J Clin Microbiol. 2005;43(5):2384–2390.
3. Guven GS, Uzun O. Principles of good use of antibiotics in hospitals. J Hosp Infect. 2003;53(2):91–96.
4. Lowy FD. Antimicrobial resistance: the example of Staphylococcus aureus. J Clin Invest. 2003;111(9):1265–1273.
5. Ako-Nai AK, Taiwo O, Ebri A, Adeniran MO. Bacterial isolates involved in cases of septicaemia in a Nigerian hospital. East Afr Med J. 1990;67(6):407–412.
6. Unachukwu CN, Obunge OK, Odia OJ. The bacteriology of diabetic foot ulcers in Port Harcourt, Nigeria. Niger J Med. 2005;14(2):173–176.
7. Ako-Nai AK, Ogunniyi AD, Lamikanra A, Torimiro SE. The characterization of clinical isolates of Staphylococcus aureus in Ile-Ife, Nigeria. J Med Microbiol. 1991;34(2):109–112.
8. Ako-Nai AK, Lamikanra AB, Onipede AO. Incidence of pathogenic microorganisms in clinical specimens from hospitals in south-western Nigeria. East Afr Med J. 1995;72(7):436–441.
9. Oni AA, Bakare RA, Okesola AO, Ogunlowo HA, Ewete AF. Pattern of bacterial pathogens in surgical wound infections. Afr J Med Med Sci. 1997;26(3–4):139–140.
10. Emele FE, Izomoh MI, Alufohai E. Microorganisms associated with wound infection in Ekpoma, Nigeria. West Afr J Med. 1999;18(2):97–100.
11. Adejuyigbe EA, Adeodu OO, Ako-Nai KA, Taiwo O, Owa JA. Septicaemia in high risk neonates at a teaching hospital in Ile-Ife, Nigeria. East Afr Med J. 2001;78(10):540–543.
12. Ako-Nai AK, Oluga FA, Onipede AO, Adejuyigbe EA, Amusa YB. The characterization of bacterial isolates from acute otitis media in Ile-Ife, southwestern Nigeria. J Trop Pediatr. 2002;48(1):15–23.
13. Odusanya OO. Antibiotic susceptibility of microorganisms at a general hospital in Lagos, Nigeria. J Natl Med Assoc. 2002;94(11):994–998.
14. National Committee for Clinical Laboratory Standards (now CLSI). Performance Standards for Antimicrobial Disk Susceptibility Tests. NCCLS document M2-A8. Wayne, Pa: National Committee for Clinical Laboratory Standards; 2003.
15. Skov R, Frimodt-Moller N, Espersen F. Correlation of MIC methods and tentative interpretive criteria for disk diffusion susceptibility testing using NCCLS methodology for fusidic acid. Diagn Microbiol Infect Dis. 2001;40(3):111–116.
16. Kim HB, Jang HC, Nam HJ, et al. In vitro activities of 28 antimicrobial agents against Staphylococcus aureus isolates from tertiary-care hospitals in Korea: a nationwide survey. Antimicrob Agents Chemother. 2004;48(4):1124–1127.
17. Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH. Practical disk diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci. J Clin Microbiol. 2003;41(10):4740–4744.
18. Udo EE, Farook VS, Mokadas EM, Jacob LE, Sanyal SC. Molecular fingerprinting of mupirocin-resistant methicillin-resistant Staphylococcus aureus from a burn unit. Int J Infect Dis. 1999;3(2):82–87.
19. Brakstad OG, Aasbakk K, Maeland JA. Detection of Staphylococcus aureus by polymerase chain reaction amplification of the nuc gene. J Clin Microbiol. 1992;30(7):1654–1660.
20. Bignardi GE, Woodford N, Chapman A, Johnson AP, Speller DC. Detection of the mec-A gene and phenotypic detection of resistance in Staphylococcus aureus isolates with borderline or low-level methicillin resistance. J Antimicrob Chemother. 1996;37(1):53–63.
21. Woodford N, Watson AP, Patel S, Jevon M, Waghorn DJ, Cookson BD. Heterogeneous location of the mupA high-level mupirocin resistance gene in Staphylococcus aureus. J Med Microbiol. 1998;47(9):829–835.
22. Bannerman TL, Hancock GA, Tenover FC, Miller JM. Pulsed-field gel electrophoresis as a replacement for bacteriophage typing of Staphylococcus aureus. J Clin Microbiol. 1995;33(3):551–555.
23. Jorgensen M, Givney R, Pegler M, Vickery A, Funnell G. Typing multidrug-resistant Staphylococcus aureus: conflicting epidemiological data produced by genotypic and phenotypic methods clarified by phylogenetic analysis. J Clin Microbiol. 1996;34(2):398–403.
24. Oliveira DC, de Lencastre H. Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2002;46(7):2155–2161.
25. Bouchillon SK, Johnson BM, Hoban DJ, et al. Determining incidence of extended spectrum beta-lactamase producing Enterobacteriaceae, vancomycin-resistant Enterococcus faecium and methicillin-resistant Staphylococcus aureus in 38 centres from 17 countries: the PEARLS study 2001–2002. Int J Antimicrob Agents. 2004;24(2):119–124.
26. Enright MC. The evolution of a resistant pathogen—the case of MRSA. Curr Opin Pharmacol. 2003;3(5):474–479.
27. Tenover FC, Lancaster MV, Hill BC, et al. Characterization of staphylococci with reduced susceptibilities to vancomycin and other glycopeptides. J Clin Microbiol. 1998;36(4):1020–1027.
28. Matynia B, Mlodzinska E, Hryniewicz W. Antimicrobial susceptibility patterns of Staphylococcus aureus in Poland obtained by the National Quality Assurance Programme. Clin Microbiol Infect. 2005;11(5):379–385.
29. Okeke IN, Lamikanra A. Quality and bioavailability of tetracycline capsules in a Nigerian semi-urban community. Int J Antimicrob Agents. 1995;5(4):245–250.
30. Okeke IN. Factors contributing to the emergence of resistance. In: Knobler SL, Lemon SM, Najafi M, Burroughs T, eds. The Resistance Phenomenon in Microbes and Infectious Disease Vectors: Implications for Human Health and Strategies for Containment—Workshop Summary. Washington, DC: The National Academies Press; 2003:132–139.
31. Rotimi VO, Orebamjo OA, Banjo TO, Onyenefa PI, Nwobu RN. Occurrence and antibiotic susceptibility profiles of methicillin-resistant Staphylococcus aureus in Lagos University Teaching Hospital. Cent Afr J Med. 1987;33(4):95–99.
32. Okesola AO, Oni AA, Bakare RA. Prevalence and antibiotic sensitivity pattern of methicillin-resistant Staphylococcus aureus in Ibadan, Nigeria. J Hosp Infect. 1999;41(1):74–75.
33. Kesah C, Ben Redjeb S, Odugbemi TO, et al. Prevalence of methicillin-resistant Staphylococcus aureus in eight African hospitals and Malta. Clin Microbiol Infect. 2003;9(2):153–156.
34. Taiwo SS, Onile BA, Akanbi AA. Methicillin-resistant Staphylococcus aureus (MRSA) isolates in Ilorin, Nigeria. Afr J Clin Exper Microbiol. 2004;5(2):189–197.
35. Adesida S, Boelens H, Babajide B, et al. Major epidemic clones of Staphylococcus aureus in Nigeria. Microb Drug Resist. 2005;11(2):115–121.
36. Enright MC, Robinson DA, Randle G, Feil EJ, Grundmann H, Spratt BG. The evolutionary history of methicillin-resistant Staphylococcus aureus (MRSA). Proc Natl Acad Sci USA. 2002;99(11):7687–7692.
37. Cookson BD. Antiseptic resistance in methicillin-resistant Staphylococcus aureus: an emerging problem. Int J Med Microbiol. 1994;26(Suppl):227–234.
38. Cookson BD. The emergence of mupirocin resistance: a challenge to infection control and antibiotic prescribing practice. J Antimicrob Chemother. 1998;41(1):11–18.
39. Perez-Roth E, Claverie-Martin F, Batista N, Moreno A, Mendez-Alvarez S. Mupirocin resistance in methicillin-resistant Staphylococcus aureus clinical isolates in a Spanish hospital. Co-application of multiplex PCR assay and conventional microbiology methods. Diagn Microbiol Infect Dis. 2002;43(2):123–128.
40. O’Neill GL, Murchan S, Gil-Setas A, Aucken HM. Identification and characterization of phage variants of a strain of epidemic methicillin-resistant Staphylococcus aureus (EMRSA-15). J Clin Microbiol. 2001;39(4):1540–1548.
41. Witte W, Enright M, Schmitz FJ, Cuny C, Braulke C, Heuck D. Characteristics of a new epidemic MRSA in Germany ancestral to United Kingdom EMRSA 15. Int J Med Microbiol. 2001;290(8):677–682.
42. Moore PCL, Lindsay JA. Molecular characterization of the dominant UK methicillin-resistant Staphylococcus aureus strains, EMRSA-15 and EMRSA-16. J Med Microbiol. 2002;51(6):516–521.
43. Melter O, Aires de Sousa M, Urbaskova P, Jakubu V, Zemlickova H, de Lencastre H. Update on the major clonal types of methicillin-resistant Staphylococcus aureus in the Czech Republic. J Clin Microbiol. 2003;41(11):4998–5005.
44. Perez-Roth E, Lorenzo-Diaz F, Batista N, Moreno A, Mendez-Alvarez S. Tracking methicillin-resistant Staphylococcus aureus clones during a 5-year period (1998 to 2002) in a Spanish hospital. J Clin Microbiol. 2004;42(10):4649–4656.
45. Udo EE, Al-Sweih N, Noronha B. Characterisation of non-multiresistant methicillin-resistant Staphylococcus aureus (including EMRSA-15) in Kuwait Hospitals. Clin Microbiol Infect. 2006;12(3):262–269.

image description image description