Abstract
Although there has been a worldwide emergence and spread of methicillin-resistant Staphylococcus aureus (MRSA), little is known about the molecular epidemiology of MRSA in Tanzania. In this study, we characterized MRSA strains isolated from clinical specimens at the Bugando Medical Centre, Tanzania, between January and December 2008. Of 160 S. aureus isolates from 600 clinical specimens, 24 (15%) were found to be MRSA. Besides molecular screening for the Panton Valentine leukocidin (PVL) genes by PCR, MRSA strains were further characterized by Multi-Locus Sequence Typing (MLST) and spa typing. Despite considerable genetic diversity, the spa types t690 (29.1%) and t7231 (41.6%), as well as the sequence types (ST) 88 (54.2%) and 1797 (29.1%), were dominant among clinical isolates. The PVL genes were detected in 4 isolates; of these, 3 were found in ST 88 and one in ST1820. Resistance to erythromycin, clindamicin, gentamicin, tetracycline and co-trimoxazole was found in 45.8%, 62.5%, 41.6%, 45.8% and 50% of the strains, respectively. We present the first thorough typing of MRSA at a Tanzanian hospital. Despite considerable genetic diversity, ST88 was dominant among clinical isolates at the Bugando Medical Centre. Active and standardized surveillance of nosocomial MRSA infection should be conducted in the future to analyse the infection and transmission rates and implement effective control measures.
Highlights
There has been a worldwide emergence and spread of methicillin-resistant Staphylococcus aureus (MRSA), little is known about the molecular epidemiology of MRSA in Tanzania
The 24 MRSA isolates could be assigned to four sequence types with ST88 being the most common sequence type detected, found in 13 (54.2%) of the isolates
Using seven housekeeping gene loci, these isolates were divided in the two clonal complexes (CC) CC88 and CC8 (Table 1)
Summary
There has been a worldwide emergence and spread of methicillin-resistant Staphylococcus aureus (MRSA), little is known about the molecular epidemiology of MRSA in Tanzania. Molecular epidemiological studies of MRSA isolates are crucial in controlling the spread of these isolates; pulsed-field gel electrophoresis (PFGE) has been the gold standard for strain typing, but it lacks an inter-laboratory reproducibility [3]. The sequencebased methods, such as staphylococcal protein Aencoding gene (spa)-typing and multi-locus sequence typing (MLST), offer excellent intra- and interlaboratory reproducibility, and the opportunity to compare results internationally [4]. In the few studies which have been conducted to characterize ST and spa types in Africa, the majority of MRSA isolates has been assigned to ST8 and ST88 [6,7]. ST 88 has recently been reported in Nigeria [8], as well as in children from Western Africa who had undergone surgery in Switzerland and who had later been hospitalized in their home
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