review · Frontiers in Microbiology
A systematic review examined the clonal diversity of methicillin-resistant Staphylococcus aureus (MRSA) across Africa between November 2014 and December 2020. Analysing 65 studies and 26 publications covering 16 African countries, the evaluation tracked genetic types and clonal complexes. The findings revealed diverse variants within clonal complexes 5 and 8 throughout the continent. Dominant clones varied by region, including ST5-IV in Angola and ST8-IV in the Democratic Republic of Congo, whilst ST88-IV was widely distributed across multiple nations. A decline was observed in healthcare-associated ST239 and ST241 clones, contrasted by expanding distributions of ST1, ST22, and ST152. Panton-Valentine leukocidin-positive strains appeared in several complexes, showing a median prevalence of 33 per cent. Overall, genomic data across Africa remains limited, pointing to the need for expanded surveillance capacity using a One-Health approach.
Methicillin-resistant Staphylococcus aureus is a multi-drug resistant pathogen that causes severe hospital and community outbreaks. Tracking which genetic variants are circulating helps public health authorities monitor transmission patterns and identify emerging strains. Establishing these regional patterns provides essential baseline information for designing infection prevention measures and coordinating continent-wide disease control strategies.
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Background Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of hospital-associated (HA) and community-associated (CA) infections globally. The multi-drug resistant nature of this pathogen and its capacity to cause outbreaks in hospital and community settings highlight the need for effective interventions, including its surveillance for prevention and control. This study provides an update on the clonal distribution of MRSA in Africa. Methods A systematic review was conducted by screening for eligible English, French, and Arabic articles from November 2014 to December 2020, using six electronic databases (PubMed, EBSCOhost, Web of Science, Scopus, African Journals Online, and Google Scholar). Data were retrieved and analyzed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (registered at PROSPERO: CRD42021277238). Genotyping data was based primarily on multilocus sequence types (STs) and Staphylococcal Cassette Chromosome mec (SCC mec ) types. We utilized the Phyloviz algorithm in the cluster analysis and categorization of the MRSA STs into various clonal complexes (CCs). Results We identified 65 studies and 26 publications from 16 of 54 (30%) African countries that provided sufficient genotyping data. MRSA with diverse staphylococcal protein A ( spa ) and SCC mec types in CC5 and CC8 were reported across the continent. The ST5-IV [2B] and ST8-IV [2B] were dominant clones in Angola and the Democratic Republic of Congo (DRC), respectively. Also, ST88-IV [2B] was widely distributed across the continent, particularly in three Portuguese-speaking countries (Angola, Cape Verde, and São Tomé and Príncipe). The ST80-IV [2B] was described in Algeria and Egypt, while the HA-ST239/ST241-III [3A] was only identified in Egypt, Ghana, Kenya, and South Africa. ST152-MRSA was documented in the DRC, Kenya, Nigeria, and South Africa. Panton–Valentine leukocidin (PVL)-positive MRSA was observed in several CCs across the continent. The median prevalence of PVL-positive MRSA was 33% (ranged from 0 to 77%; n = 15). Conclusion We observed an increase in the distribution of ST1, ST22, and ST152, but a decline of ST239/241 in Africa. Data on MRSA clones in Africa is still limited. There is a need to strengthen genomic surveillance capacity based on a “One-Health” strategy to prevent and control MRSA in Africa.
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DOI: 10.3389/fmicb.2022.860436
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