title: Community-Associated Staphylococcus aureus from Sub-Saharan Africa and Germany: A Cross-Sectional Geographic Correlation Study.
abstract: Clonal clusters and gene repertoires of Staphylococcus aureus are essential to understand disease and are well characterized in industrialized countries but poorly analysed in developing regions. The objective of this study was to compare the molecular-epidemiologic profiles of S. aureus isolates from Sub-Saharan Africa and Germany. S. aureus isolates from 600 staphylococcal carriers and 600 patients with community-associated staphylococcal disease were characterized by DNA hybridization, clonal complex (CC) attribution, and principal component (PCA)-based gene repertoire analysis. 73% of all CCs identified representing 77% of the isolates contained in these CCs were predominant in either African or German region. Significant differences between African versus German isolates were found for alleles encoding the accessory gene regulator type, enterotoxins, the Panton-Valentine leukocidin, immune evasion gene cluster, and adhesins. PCA in conjunction with silhouette analysis distinguished nine separable PCA clusters, with five clusters primarily comprising of African and two clusters of German isolates. Significant differences between S. aureus lineages in Africa and Germany may be a clue to explain the apparent difference in disease between tropical/(so-called) developing and temperate/industrialized regions. In low-resource countries further clinical-epidemiologic research is warranted not only for neglected tropical diseases but also for major bacterial infections.
authors.affiliation: Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
authors.forename: Ulla
authors.initials: U
authors.lastname: Ruffing
authors.affiliation: Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon.
authors.forename: Abraham
authors.initials: A
authors.lastname: Alabi
authors.affiliation: Ifakara Health Research and Development Centre (IHRDC), Dar es Salaam, Tanzania.
authors.forename: Theckla
authors.initials: T
authors.lastname: Kazimoto
authors.affiliation: Manhiça Health Research Center, Manhiça, Manhiça, Mozambique.
authors.forename: Delfino C
authors.initials: DC
authors.lastname: Vubil
authors.affiliation: Center for Bioinformatics, Saarland University, Saarbrücken, Germany.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Akulenko
authors.affiliation: Ifakara Health Research and Development Centre (IHRDC), Dar es Salaam, Tanzania.
authors.forename: Salim
authors.initials: S
authors.lastname: Abdulla
authors.affiliation: Manhiça Health Research Center, Manhiça, Manhiça, Mozambique.|Department of Public Health, University of Barcelona, Barcelona, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Alonso
authors.affiliation: Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Bischoff
authors.affiliation: Fraunhofer Institute for Biomedical Engineering, St. Ingbert, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Germann
authors.affiliation: Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon.|Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
authors.affiliation: Center for Bioinformatics, Saarland University, Saarbrücken, Germany.
authors.forename: Volkhard
authors.identifier: 0000-0002-2180-9154
authors.initials: V
authors.lastname: Helms
authors.affiliation: Division of Infectious Diseases and Travel Medicine, University of Freiburg, Freiburg, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Hoffmann
authors.affiliation: Division of Infectious Diseases and Travel Medicine, University of Freiburg, Freiburg, Germany.
authors.forename: Winfried V
authors.initials: WV
authors.lastname: Kern
authors.affiliation: Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon.|Institute of Tropical Medicine, University of Tübingen, Deutsches Zentrum für Infektionsforschung, Tübingen, Germany.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kremsner
authors.affiliation: Manhiça Health Research Center, Manhiça, Manhiça, Mozambique.
authors.forename: Inacio
authors.initials: I
authors.lastname: Mandomando
authors.affiliation: Institute of Hygiene, University Hospital Münster, Münster, Germany.
authors.forename: Alexander
authors.identifier: 0000-0002-0649-5185
authors.initials: A
authors.lastname: Mellmann
authors.affiliation: Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Peters
authors.affiliation: Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.
authors.forename: Frieder
authors.initials: F
authors.lastname: Schaumburg
authors.affiliation: Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Schubert
authors.affiliation: Institute of Hygiene, University Hospital Münster, Münster, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Strauß
authors.affiliation: Ifakara Health Research and Development Centre (IHRDC), Dar es Salaam, Tanzania.|Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.affiliation: Fraunhofer Institute for Biomedical Engineering, St. Ingbert, Germany.
authors.forename: Hagen von
authors.initials: HV
authors.lastname: Briesen
authors.affiliation: Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Wende
authors.affiliation: Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
authors.forename: Lutz von
authors.identifier: 0000-0001-9013-4245
authors.initials: LV
authors.lastname: Müller
authors.affiliation: Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany. mathias.herrmann@uni-muenster.de.
authors.forename: Mathias
authors.initials: M
authors.lastname: Herrmann
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D058974:Phylogeography; D025341:Principal Component Analysis; D013203:Staphylococcal Infections / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D055815:Young Adult