Abstract
Background: The emergence of community-acquired Staphylococcus aureus infections is increasingly recognized as life threating problem worldwide. In Manhiça district, southern Mozambique, S. aureus is the leading cause of community-acquired bacteremia in neonates.Methods: Eighty-four S. aureus isolates from children less than 5 years admitted to Manhiça District Hospital from 2001 to 2009 were randomly selected and genetically characterized by DNA microarray and spa typing. Antimicrobial susceptibility was determined by VITEK 2.Results: Thirty-eight different spa types and 14 clonal complexes (CC) were identified. Spa-type t084 (n = 10; 12%) was the most predominant while CC8 (n = 18; 21%) and CC15 (n = 14; 16%) were the most frequent CCs. Mortality tended to be higher among children infected with CC45 (33.3%, 1/3) and CC8 (27.8%, 5/18). The majority of isolates possessed the accessory gene regulator I (45%) and belonged to either capsule type 8 (52%) or 5 (47%). Panton valentine leukocidin (PVL) encoding genes were detected in 30%. Antibiotic resistance was high for penicillin (89%), tetracycline (59%) and Trimethoprim Sulfamethoxazole (36%) while MRSA was uncommon (8%).Conclusions: Although MRSA were uncommon, we found high genetic diversity of methicillin susceptible S. aureus causing bacteremia in Mozambican children, associated with high resistance to the most available antibiotics in this community. Some CCs are likely to be more lethal indicating the need for prompt recognition and appropriate treatment.
Highlights
Staphylococcus aureus is an important cause of human infections ranging from skin abscesses to life threatening conditions such as bacteremia and pneumonia
The ability of S. aureus to cause multiple infections has been associated with the expression of myriads of different toxins, virulence factors, cell wall adhesion proteins such as MSCRAMMs (Microbial Surface Components Recognizing Adhesive Matrix Molecules) and other proteins involved in immune evasion (Shambat et al, 2012)
During the study period (January 2001 to December 2009), 32,488 blood cultures were performed from children less than 5 years yielding a positivity rate of 8% (n = 2,748) of which 398 (14%) of the positives were S. aureus
Summary
Staphylococcus aureus is an important cause of human infections ranging from skin abscesses to life threatening conditions such as bacteremia and pneumonia. This pathogen is able to cause hospital as well as community acquired infections (Chen and Huang, 2014). Different S. aureus may have different constellations of MSCRAMMs and so may be predisposed to cause certain types of infections (Gordon and Lowy, 2008) Toxins are another group of critical virulence factors, among them the Panton–Valentine Leukocidin (PVL) is of particular importance. In Manhiça district, southern Mozambique, S. aureus is the leading cause of community-acquired bacteremia in neonates
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