Published in:
01-07-2021 | Ciprofloxacin | Original Article
Predominance of PVL-negative community-associated methicillin-resistant Staphylococcus aureus sequence type 8 in newly diagnosed HIV-infected adults, Tanzania
Authors:
Joel Manyahi, Sabrina J. Moyo, Said Aboud, Nina Langeland, Bjørn Blomberg
Published in:
European Journal of Clinical Microbiology & Infectious Diseases
|
Issue 7/2021
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Abstract
Difficult-to-treat infections caused by methicillin-resistant
Staphylococcus aureus (MRSA) are of concern in people living with HIV infection as they are more vulnerable to infection. We aimed to identify molecular characteristics of MRSA colonizing newly diagnosed HIV-infected adults in Tanzania. Individuals newly diagnosed with HIV infection were recruited in Dar es Salaam, Tanzania, from April 2017 to May 2018, as part of the randomized clinical trial CoTrimResist (
ClinicalTrials.gov identifier: NCT03087890). Nasal/nasopharyngeal isolates of
Staphylococcus aureus were susceptibility tested by disk diffusion method, and cefoxitin-resistant isolates were characterized by short-reads whole genome sequencing. Four percent (22/537) of patients carried MRSA in the nose/nasopharynx. MRSA isolates were frequently resistant towards gentamicin (95%), ciprofloxacin (91%), and erythromycin (82%) but less often towards trimethoprim-sulfamethoxazole (9%). Seventy-three percent had inducible clindamycin resistance. Erythromycin-resistant isolates harbored
ermC (15/18) and
LmrS (3/18) resistance genes. Ciprofloxacin resistance was mediated by mutations of the quinolone resistance-determining region (QRDR) sequence in the
gyrA (S84L) and
parC (S80Y) genes. All isolates belonged to the CC8 and ST8-SCC
mecIV MRSA clone. Ninety-five percent of the MRSA isolates were
spa-type t1476, and one exhibited
spa-type t064. All isolates were negative for Panton-Valentine leucocidin (PVL) and arginine catabolic mobile element (ACME) type 1. All ST8-SCC
mecIV-
spa-t1476 MRSA clones from Tanzania were unrelated to the globally successful USA300 clone. Carriage of ST8 MRSA (non-USA300) was common among newly diagnosed HIV-infected adults in Tanzania. Frequent co-resistance to non-beta lactam antibiotics limits therapeutic options when infection occurs.