Nasopharyngeal Carriage of Methicillin-Resistant <i>Staphylococcus aureus</i> (MRSA) among Sickle Cell Disease (SCD) Children in the Pneumococcal Conjugate Vaccine Era

• Main Authors: Nicholas T. K. D. Dayie (Author), Deborah N. K. Sekoh (Author), Fleischer C. N. Kotey (Author), Beverly Egyir (Author), Patience B. Tetteh-Quarcoo (Author), Kevin Kofi Adutwum-Ofosu (Author), John Ahenkorah (Author), Mary-Magdalene Osei (Author), Eric S. Donkor (Author)
• Format: Book
• Published: MDPI AG, 2021-03-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

The aim of this cross-sectional study was to investigate <i>Staphylococcus aureus</i> nasopharyngeal carriage epidemiology in relation to other nasopharyngeal bacterial colonizers among sickle cell disease (SCD) children about five years into pneumococcal conjugate vaccine 13 (PCV-13) introduction in Ghana. The study involved bacteriological culture of nasopharyngeal swabs obtained from 202 SCD children recruited from the Princess Marie Louise Children's Hospital. <i>S. aureus</i> isolates were identified using standard methods and subjected to antimicrobial susceptibility testing using the Kirby-Bauer disc diffusion method. Cefoxitin-resistant <i>S. aureus</i> isolates were screened for carriage of the <i>mecA</i>, <i>pvl</i>, and <i>tsst-1</i> genes using multiplex polymerase chain reaction. The carriage prevalence of <i>S. aureus</i> was 57.9% (<i>n</i> = 117), and that of methicillin-resistant <i>S. aureus</i> (MRSA) was 3.5% (<i>n</i> = 7). Carriage of the <i>mecA</i>, <i>pvl</i>, and <i>tsst-1</i> genes were respectively demonstrated in 20.0% (<i>n</i> = 7), 85.7% (<i>n</i> = 30), and 11.4% (<i>n</i> = 4) of the cefoxitin-resistant <i>S. aureus</i> isolates. PCV-13 vaccination (<i>OR</i> = 0.356, <i>p</i> = 0.004) and colonization with coagulase-negative staphylococci (CoNS) (<i>OR</i> = 0.044, <i>p</i> < 0.0001) each protected against <i>S. aureus</i> carriage. However, none of these and other features of the participants emerged as a determinant of MRSA carriage. The following antimicrobial resistance rates were observed in MRSA compared to methicillin-sensitive <i>S. aureus</i>: clindamycin (28.6% vs. 4.3%), erythromycin (42.9% vs. 19.1%), tetracycline (100% vs. 42.6%), teicoplanin (14.3% vs. 2.6%), penicillin (100% vs. 99.1%), amoxiclav (28.6% vs. 3.5%), linezolid (14.3% vs. 0.0%), ciprofloxacin (42.9% vs. 13.9%), and gentamicin (42.9% vs. 13.0%). The proportion of <i>S. aureus</i> isolates that were multidrug resistant was 37.7% (<i>n</i> = 46). We conclude that <i>S. aureus</i> was the predominant colonizer of the nasopharynx of the SCD children, warranting the continuous monitoring of this risk group for invasive <i>S. aureus</i> infections.

Item Description

10.3390/idr13010022
2036-7449