Whole Genome Sequencing and Antimicrobial Resistance of Staphylococcus aureus from Surgical Site Infections in Ghana
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
MDPI
Abstract
Staphylococcus aureus (S. aureus) is a common cause of surgical site infections (SSIs) globally.
Data on the occurrence of methicillin-susceptible S. aureus (MSSA) as well as methicillin-resistant
S. aureus (MRSA) among patients with surgical site infections (SSIs) in sub-Saharan African are
scarce. We characterized S. aureus from SSIs in Ghana using molecular methods and antimicrobial
susceptibility testing (AST). Wound swabs or aspirate samples were collected from subjects with
SSIs. S. aureus was identified by matrix-assisted laser desorption ionization–time of flight mass
spectrometry (MALDI-TOF-MS); AST was performed by Kirby-Bauer disk diffusion, and results were
interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guideline. Detection
of spa, mecA, and pvl genes was performed by polymerase chain reaction (PCR). Whole-genome
sequencing (WGS) was done using the Illumina MiSeq platform. Samples were collected from
112 subjects, with 13 S. aureus isolates recovered. Of these, 92% were sensitive to co-trimoxazole, 77%
to clindamycin, and 54% to erythromycin. Multi-drug resistance was detected in 5 (38%) isolates. The
four mecA gene-positive MRSA isolates detected belonged to ST152 (n = 3) and ST5 (n = 1). In total,
62% of the isolates were positive for the Panton-Valentine leukocidin (pvl) toxin gene. This study
reports, for the first time, a pvl-positive ST152-t355 MRSA clone from SSIs in Ghana. The occurrence
of multi-drug-resistant S. aureus epidemic clones suggests that continuous surveillance is required to
monitor the spread and resistance trends of S. aureus in hospital settings in the country.
Description
Research Article
Keywords
surgical site infections, MRSA, whole-genome sequencing, Africa