title: Characterisation of Staphylococcus aureus isolates from bloodstream infections, Democratic Republic of the Congo.
abstract: Staphylococcus aureus is known worldwide as an invasive pathogen, but information on S. aureus from bloodstream infections in Central Africa remains scarce. A collection of S. aureus blood culture isolates recovered from hospitals in four provinces in the Democratic Republic of the Congo (2009-2013) was assessed. A total of 27/108 isolates were methicillin-resistant S. aureus (MRSA), of which >70% were co-resistant to aminoglycosides, tetracyclines, macrolides and lincosamides. For MRSA and methicillin-susceptible S. aureus (MSSA) isolates, resistance to chloramphenicol and trimethoprim-sulphamethoxazole (TMP-SMX) was <10%. However, 66.7% (72/108) of all isolates harboured the trimethoprim resistance gene dfrG. More than three-quarters (84/108, 77.8%) of isolates belonged to CC5, CC8, CC121 or CC152. Genetic diversity was higher among MSSA (31 spa types) compared to MRSA (four spa types). Most MRSA (23/27, 85.2%) belonged to CC8-spa t1476-SCCmec V and 17/23 (73.9%) MRSA ST8 were oxacillin susceptible but cefoxitin resistant. Among MRSA and MSSA combined, 49.1% (53/108) and 19.4% (21/108) contained the genes encoding for Panton-Valentine leucocidin (lukS-lukF PV, PVL) and toxic shock syndrome toxin-1 (tst, TSST-1), respectively. PVL was mainly detected among MSSA (51/53 isolates harbouring PVL were MSSA, 96.2%) and associated with CC121, CC152, CC1 and CC5. TSST-1 was associated with CC8-spa t1476-SCCmec V. The immune evasion cluster (IEC) genes scn, sak and chp were detected in 81.5% of isolates (88/108, equally represented among MSSA and MRSA). The present study confirms the occurrence of MRSA with high levels of multidrug co-resistance and PVL-positive MSSA among invasive S. aureus isolates in Central Africa.
authors.affiliation: National Reference Centre for Staphylococcus aureus, Laboratory of Microbiology, Université Libre de Bruxelles (ULB), Brussels, Belgium. stien.vandendriessche@ugent.be.|Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium. stien.vandendriessche@ugent.be.
authors.forename: S
authors.identifier: http://orcid.org/0000-0002-3501-0140
authors.initials: S
authors.lastname: Vandendriessche
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: De Boeck
authors.affiliation: National Reference Centre for Staphylococcus aureus, Laboratory of Microbiology, Université Libre de Bruxelles (ULB), Brussels, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Deplano
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium.
authors.forename: M-F
authors.initials: MF
authors.lastname: Phoba
authors.affiliation: Department of Clinical Microbiology, National Institute for Biomedical Research Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo.|Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: O
authors.initials: O
authors.lastname: Lunguya
authors.affiliation: Department of Pediatrics, University Hospital of Kisangani, Kisangani, Democratic Republic of the Congo.
authors.forename: D
authors.initials: D
authors.lastname: Falay
authors.affiliation: Department of Clinical Microbiology, National Institute for Biomedical Research Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo.|Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: N
authors.initials: N
authors.lastname: Dauly
authors.affiliation: Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Verhaegen
authors.affiliation: National Reference Centre for Staphylococcus aureus, Laboratory of Microbiology, Université Libre de Bruxelles (ULB), Brussels, Belgium.
authors.forename: O
authors.initials: O
authors.lastname: Denis
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium.|Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Jacobs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D015023:Democratic Republic of the Congo; D024881:Drug Resistance, Bacterial; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D037521:Virulence Factors