Molecular Diversity of <i>Staphylococcus aureus</i>from the Nares of Hospital Personnel, HIV-Positive and Diabetes Mellitus Patients in Yaounde Cameroon

Nasal carriage of Staphylococcus aureus has been identified as a risk factor for the development of staphylococcal infections caused by endogenous colonizing strains. Information on the genotypic diversity of Staphylococcus aureus is relevant for managing epidemiological and clinical challenges resulting from the evolutionary differences of this bacterium. The objective of this study was to determine and compare the molecular diversity of Staphylococcus aureus isolates from three high-risk populations in Yaounde, Cameroon. Molecular analysis confirmed that 95% of 100 tested isolates were S. aureus. The mecA and Panton Valentine-Leukocidin (PVL) genes (lukS/F-PV) were detected in 37% (35/95) and 43% (41/95) of isolates respectively and 18% (17/95) of the isolates harboured both the mecA and lukS/F-PV genes. A mixed distribution of both methicillin sensitive S. aureus (MSSA)/PVL and methicillin resistant S. aureus (MRSA)/PVL strains were detected within the study population. Community associated MRSA accounted for 94% (33/35) of the isolates, further classified into allotypes SCCmec type IV 54% (19/35) and SCCmec type V 40% (14/35), while two isolates were hospital associated SCCmec type II strains. A majority of the isolates harboured a single aggressive gene regulator allele agr type I. Pulsed Field Gel Electrophoresis (PFGE) generated 18 pulsotypes that grouped isolates irrespective of the study population. Multilocus Sequence Typing (MLST) of 12 selected isolates was assigned to six pandemic clonal complexes (CC): CC5 (ST5), CC8 [ST8, (n = 3)], CC15 (ST 15), CC25 (ST 25), CC72 [ST72 (n = 2)] and CC121 [ST 121 (n = 2)] and three atypical sequence types ST 508, ST 699 (CC45) and ST 1289 (CC 88). The study population represents an important reservoir for MRSA, MRSA-PVL and MSSA-PVL which could serve as focal point for further dissemination bringing about significant clinical and epidemiological implications. The predominance of SCCmec IV and agr types in this setting warrants further investigation. Isolates were genetically diverse with MLST indicating that pandemic ST8 was predominant. Detection of atypical STs has provided an insight into the necessity for constant monitoring.

High Prevalence of Multidrug Resistant <i>Klebsiella</i>Species Isolated from the Yaounde University Teaching Hospital, Cameroon

Background and Purpose: Klebsiella species are amongst the most common causes of a variety of community-acquired and hospital-acquired infections (HAI), characterized by high morbidity and mortality rates. Most infections caused by Klebsiella species are usually treated using antibiotics. The aim of this study was to determine the antimicrobial resistance profile of Klebsiella species isolated from in-patients and out-patients at the Yaounde University Teaching Hospital. The data generated will go a long way to improve on the choice of an adequate empiric antibiotic treatment for infections caused by Klebsiella species. Methodology: A cross-sectional descriptive study was carried out over a period of 6 months, spanning from February 2019 to July 2019 with a sample size of 37 isolates, obtained from 6 different clinical specimens. Identification of isolates was done using API 20E identification system (Biomerieux SA, Lyon, France). Susceptibility to antibiotics was tested as described by Kirby-Bauer in 1956. Inhibition diameters were interpreted according to recommendations from the European Committee on Antimicrobial Susceptibility Testing (EUCAST, 2019). Results and Conclusion: Among the 37 Klebsiella isolates identified, Klebsiella pneumoniae was the most prevalent species isolated with a percentage of 54.1%, followed by Klebsiella rhinoscleromatis 18.9%, Klebsiella ozaenae 16.2% and Klebsiella oxytoca, 10.8%. The resistance pattern of Klebsiella to amoxicillin, amoxicillin/clavulanate, tircacillin, tircacillin + clavulanic acid, piperacillin, piperacillin + tazobactam, cefalotin, cefuroxim, ceftazidime, cefotaxime, ceftriaxone, cefepime, imipenem, meropenem, aztreonam, amikacin, gentamicin, tobramycin, trimethoprim/ sulfamethoxazole, nalidixic acid, pipemidic acid, norfloxacin, ciprofloxacin, levofloxacin, ofloxacin, and moxifoxacin was as follows;100%, 86.5%, 97.3%, 83.6%, 86.5%, 16.2%, 86.5%, 83.8%, 78.4%, 32.4%, 78.4%, 76.7%, 2.7%, 2.7%, 76.7%, 13.5%, 75.7%, 73.0%, 91.9%, 51.4%, 48.6%, 64.9%, 48.6%, 48.6%, 73.0% and 62.2% respectively. Multidrug resistance was observed in 94.6% of the Klebsiella isolates. Conclusion: This study shows that the level of multidrug resistance is high. The isolates expressed good sensitivity to carbapenems, piperacillin + tazobactam, amikacin and high resistance to all other antimicrobials tested. Therefore, antimicrobial susceptibility testing prior to prescriptions should be encouraged and sensitization of the population about consequences of inappropriate antibiotic treatment and auto medication should be enforced as a means to curb antimicrobial resistance.