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Characterisation of Staphylococcus aureus isolates from bloodstream infections, Democratic Republic of the Congo

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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.

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Acknowledgements

The authors would like to thank Brigitte Mapendo, Marleen Verlinden and Edmonde Bonebe for the technical assistance.

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Author notes

  1. S. Vandendriessche

    Present address: Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium

Authors and Affiliations

  1. National Reference Centre for Staphylococcus aureus, Laboratory of Microbiology, Université Libre de Bruxelles (ULB), Brussels, Belgium

    S. Vandendriessche, A. Deplano & O. Denis

  2. Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium

    H. De Boeck, M.-F. Phoba & J. Jacobs

  3. Department of Clinical Microbiology, National Institute for Biomedical Research Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo

    O. Lunguya & N. Dauly

  4. Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo

    O. Lunguya & N. Dauly

  5. Department of Pediatrics, University Hospital of Kisangani, Kisangani, Democratic Republic of the Congo

    D. Falay

  6. Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

    J. Verhaegen & J. Jacobs

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  1. S. Vandendriessche
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Correspondence to S. Vandendriessche.

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Funding

This work was supported by the Belgian Directorate of Development Cooperation (DGD) through Project 2.01 of the Third Framework Agreement between the Belgian Directorate General of Development Cooperation (DGD, Ministry of Development Cooperation) and the Institute of Tropical Medicine (ITM), Belgium. The department of paediatrics and laboratory of the University Hospital of Kisangani (CUKIS) are sponsored by the collaboration with KU Leuven in the project ZRDC2009EIN6 of the Flemish Interuniversity Council (VLIR-UOS), funded by the Belgian DGD. The National Reference Centre for S. aureus is supported by a funding from the Institute of Public Health (ISP-WIV). The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.

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Ethical approval

The present project was carried out in the scope of a project of Antimicrobial Surveillance in Tropical Settings, for which ethical clearance had been obtained at the Institutional Review Board of the Institute of Tropical Medicine (ref. IRB/AB/ec/56), as well as from the University Hospital of Antwerp (ref. 8/20/96) and the Ministry of Health, DRC.

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Vandendriessche, S., De Boeck, H., Deplano, A. et al. Characterisation of Staphylococcus aureus isolates from bloodstream infections, Democratic Republic of the Congo. Eur J Clin Microbiol Infect Dis 36, 1163–1171 (2017). https://doi.org/10.1007/s10096-017-2904-0

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