title: Methicillin-resistant Staphylococcus aureus strains from Ghana include USA300.
abstract: The objective of this study was to provide baseline information on circulating methicillin-resistant Staphylococcus aureus (MRSA) clones in Ghana. Thirty MRSA isolates collected between 2010 and 2013 from patients and healthy carriers were characterised by DNA microarray analysis, staphylococcal protein A (spa) typing, multilocus sequence typing (MLST) and minimum inhibitory concentration (MIC) determination to 21 antimicrobial agents. Phenotypic resistance was detected to tetracycline (67%), norfloxacin (40%), moxifloxacin (37%), erythromycin (37%), clindamycin (33%), gentamicin (30%), kanamycin (30%) and ceftaroline (20%), whereas no resistance was observed for glycopeptides, linezolid, daptomycin and tigecycline. DNA microarray analysis showed that tet(M) (43%), tet(K) (33%), aphA3 (23%), aacA-aphD (17%) and erm(C) (13%) were the most prevalent resistance genes. ST88-IV (WA MRSA-2) (n=8), ST8-IV (USA300) (n=5) containing arginine catabolic mobile element (ACME) and Panton-Valentine leukocidin (PVL), and ST247-I (North German/Iberian EMRSA) (n=4) were the most frequent clones detected. All MRSA contained sak and scn genes, one isolate (ST36-II) harboured the gene encoding the toxic shock syndrome toxin (TSST) and none contained exfoliative toxin genes. In conclusion, the relatively high levels of resistance to easily accessible non-β-lactam agents further complicate the treatment of MRSA infections in Ghana. The occurrence of USA300 and other epidemic multidrug-resistant MRSA clones in this African country is a matter of public health concern due to the lack of adequate infrastructures for MRSA surveillance and control in this geographical setting.
authors.affiliation: Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark; Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Bacteriology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana. Electronic address: begyir@sund.ku.dk.
authors.forename: Beverly
authors.initials: B
authors.lastname: Egyir
authors.affiliation: Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Luca
authors.initials: L
authors.lastname: Guardabassi
authors.affiliation: Institute for Medical Microbiology and Hygiene, Technical University of Dresden, Dresden, Germany; Alere Technologies GmbH, Jena, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Monecke
authors.affiliation: Bacteriology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana.
authors.forename: Kennedy Kwasi
authors.initials: KK
authors.lastname: Addo
authors.affiliation: Microbiology Department, University of Ghana Medical School, Accra, Ghana.
authors.forename: Mercy Jemima
authors.initials: MJ
authors.lastname: Newman
authors.affiliation: Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Anders Rhod
authors.initials: AR
authors.lastname: Larsen
keywords: Africa; Antibiotic resistance; DNA microarray; MRSA; USA300; Virulence