Abstract
BackgroundPandemic community-acquired methicillin-resistant Staphylococcus aureus isolates (CA-MRSA) predominantly encode the Panton-Valentine leukocidin (PVL), which can be associated with severe infections. Reports from non-indigenous Sub-Saharan African populations revealed a high prevalence of PVL-positive isolates. The objective of our study was to investigate the S. aureus carriage among a remote indigenous African population and to determine the molecular characteristics of the isolates, particularly those that were PVL-positive.Methodology/Principal FindingsNasal S. aureus carriage and risk factors of colonization were systematically assessed in remote Gabonese Babongo Pygmies. Susceptibility to antibiotics, possession of toxin-encoding genes (i.e., PVL, enterotoxins, and exfoliative toxins), S. aureus protein A (spa) types and multi-locus sequence types (MLST) were determined for each isolate. The carriage rate was 33%. No MRSA was detected, 61.8% of the isolates were susceptible to penicillin. Genes encoding PVL (55.9%), enterotoxin B (20.6%), exfoliative toxin D (11.7%) and the epidermal cell differentiation inhibitor B (11.7%) were highly prevalent. Thirteen spa types were detected and were associated with 10 STs predominated by ST15, ST30, ST72, ST80, and ST88.ConclusionsThe high prevalence of PVL-positive isolates among Babongo Pygmies demands our attention as PVL can be associated with necrotinzing infection and may increase the risk of severe infections in remote Pygmy populations. Many S. aureus isolates from Babongo Pygmies and pandemic CA-MRSA-clones have a common genetic background. Surveillance is needed to control the development of resistance to antibiotic drugs and to assess the impact of the high prevalence of PVL in indigenous populations.
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a community-acquired pathogen in many countries throughout the world
The high prevalence of Panton-Valentine leukocidin (PVL)-positive isolates among Babongo Pygmies demands our attention as PVL can be associated with necrotinzing infection and may increase the risk of severe infections in remote Pygmy populations
Many S. aureus isolates from Babongo Pygmies and pandemic community-acquired methicillin-resistant Staphylococcus aureus isolates (CA-MRSA)-clones have a common genetic background
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a community-acquired pathogen in many countries throughout the world (community-acquired MRSA, CA-MRSA). Population analysis of global methicillin-susceptible S. aureus (MSSA) isolates associated with PVL have recently indicated that PVL-positive MSSA and MRSA are phylogenetically related based on molecular epidemiological profiles and are dynamically interrelating [6]. It was shown, that PVLpositive MSSA are a likely reservoir for the development of PVLpositive MRSA [6] via integration of Staphylococcus cassette chromosome mec (SCCmec) elements including the mecA gene conferring methicillin resistance. Pandemic community-acquired methicillin-resistant Staphylococcus aureus isolates (CA-MRSA) predominantly encode the Panton-Valentine leukocidin (PVL), which can be associated with severe infections. The objective of our study was to investigate the S. aureus carriage among a remote indigenous African population and to determine the molecular characteristics of the isolates, those that were PVL-positive
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